Historically, déjà vu has been linked to seizure activity in temporal lobe epilepsy, and clinical reports suggest that many patients experience the phenomenon as a manifestation of simple partial seizures. We review studies on déjà vu in epilepsy with reference to recent advances in the understanding of déjà vu from a cognitive and neuropsychological standpoint. We propose a decoupled familiarity hypothesis, whereby déjà vu is produced by an erroneous feeling of familiarity which is not in keeping with current cognitive processing. Our hypothesis converges on a parahippocampal dysfunction as the locus of déjà vu experiences. However, several other temporal lobe structures feature in reports of déjà vu in epilepsy. We suggest that some of the inconsistency in the literature derives from a poor classification of the various types of déjà experiences. We propose déjà vu/déjà vécu as one way of understanding déjà experiences more fully. This distinction is based on current models of memory function, where déjà vu is caused by erroneous familiarity and déjà vécu by erroneous recollection. Priorities for future research and clinical issues are discussed. 1. Introduction Déjà vu is a transitory mental state whereby a novel experience, such as a first time visit to a new city, feels as if it is familiar. Although the scientific literature on déjà vu is limited, much of it comes from the study of epilepsy, and it is this literature that we review here. Following a recent upsurge of interest in déjà vu following an influential review [1], experimental paradigms have been developed which produce an analogue of déjà vu in the laboratory (e.g., [2–4]). In this paper we take the view that déjà vu is a memory-based illusion, originating from the erroneous activation of the epistemic feeling of familiarity. As such, we are interested in how déjà vu is experienced in epilepsy, how it relates to memory in epilepsy more generally, and neural accounts of recognition memory in epilepsy. In turn, we elucidate what the study of epilepsy can contribute to our understanding of the déjà vu phenomenon. The study of déjà experiences in temporal lobe epilepsy (TLE) has a long history, dating back at least to Hughlings-Jackson’s 19th century description of the “dreamy state [5]”: “[W]hat is occupying the attention is what has occupied it before, and indeed has been familiar, but has been for a time forgotten, and now is recovered with a slight sense of satisfaction as if it had been sought for. Hughlings-Jackson (1888, page 202).” Hughlings-Jackson [6] coined the phrase “dreamy
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