Been There, Done That??

By Peter Galvin, MD

You know, medicine is a serious business. Most of my columns deal with heavy issues, often involving life and death concerns. So today and next week, I thought I’d lighten things up. Yogi Berra was known for some hilarious yet unintentional quotes. One of them was “It’s déjà vu all over again,” although I must admit that my favorite Yogi-isms are “Nobody goes there anymore. It’s too crowded” and “Ninety percent of the game [baseball] is half mental.” If, like most people, you’ve had a sneaking suspicion that you’re in a situation you’ve experienced before, that’s déjà vu. Of course, the term is French, and it means “already seen.” It was first coined in 1876 by the French philosopher Emile Boirac (1851-1917). It’s the weird feeling you get when you’re in a situation that feels like you’ve already lived it and are somehow living through it again. Only you didn’t.

There is a direct relationship between déjà vu and seizures, specifically temporal lobe seizures, which make sense because the brain’s temporal lobe is responsible for memory. Temporal lobe seizures can have visual, auditory, olfactory (smell), or gustative (taste) elements. Schizophrenia is caused by a temporal lobe disorder. Disorientation is a major factor in schizophrenia. Déjà vu is also associated with migraine headaches that have an aura (symptoms that occur before the onset of a headache). But plenty of people experience déjà vu who don’t have a history of seizures or migraines. In these people, déjà vu is thought to be caused by a memory mismatch, where a new experience bypasses short-term memory and is instead stored in long-term memory. In short, it’s a brain glitch. Déjà vu is more common in younger people, those with higher socioeconomic status, and better educational achievement. Recurrent déjà vu is indicative of a neurological or psychiatric disorder.

There are a few other conditions related to déjà vu. They are:

• Jamais vu – “never seen.” It is a common experience when someone doesn’t recognize a word, person, or place they already know. It is associated with aphasia (inability to speak), amnesia, and epilepsy.
• Deja vecu – “already lived.” An intense but false feeling of having lived through the present situation. It is a pathological form of déjà vu. The person cannot tell that the feeling of familiarity is not real. The person may justify feelings of familiarity with beliefs bordering on delusional.
• Presque vu – “almost seen.” An intense feeling of being on the brink of a powerful epiphany, insight, or revelation without actually achieving it. It is associated with profound frustration and a sense of incompleteness.
• Deja entendu – “already heard.” Being sure about having already heard something, even though the details are uncertain or maybe imagined.

More fun to come next week.

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