Recent neuroimaging studies show that human rapid-eye-movement (REM) sleep is characterized by a specific pattern of regional brain activity. Although this is usually interpreted in relation to physiological and cellular mechanisms, the specific regional distribution of brain activity during REM sleep might also be linked to specific dream features. Remarkably, several bizarre features of normal dreams have similarities with well-known neuropsychological syndromes after brain damage, such as delusional misidentifications for faces and places. We propose that neuropsychological analysis of dream content might offer new ways of interpreting neuroimaging maps of sleep, and make specific predictions for future neuroimaging studies.