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"Life is surreal. Don't let it consume you," warns Mitsuko's friend. It turns out to be vital advice.

By the time that advice is given, Mitsuko's day has already got off to a rocky start. A distinctly surreal, horrific accident on the school bus has left her the sole survivor; she has been pursued by something utterly monstrous; and yet at school, nobody seems to know anything about it. They laugh and joke and talk about boys. Except for Aki, who only has eyes for our heroine and promises to take care of her no matter what. It's a promise that will come to matter a great deal, as Mitsuko's day is about to get much stranger.

This is a world at once familiar and bizarre. Familiar, that is, to fans of Japanese cinema and video games, in which it's not unusual to see girls and young women shrieking and covered in blood, pursued by monsters, randomly shot at, forced to fight and run to the point of exhaustion just to survive. Bizarre because scenarios like this keep happening to Mitsuko again and again - if, indeed, she remains Mitsuko, since her name, clothes and physical appearance keep changing, with new groups of strangers welcoming her into their lives each time, treating her as amnesiac who - if she tells them anything at all - much just have had a strange dream.

The chances are that you've had dreams like this yourself, each time thinking you've woken up, each time feeling more exhausted as you struggle to break through into true wakefulness. Be reassured: Sono's premise is cleverer than that, and for all its strangeness, the fractured narrative eventually makes coherent sense. When it does, it's staggeringly bleak, and not just in terms of what it means for Mitsuko personally. The gore effects we see throughout (courtesy of effects master Yoshihiro Nishimura) are spectacular and sometimes genuinely shocking, but ultimately it's the existential horror underlying the plot that lingers.

Taking only the bare bones of its story from the book that inspired it, this film is as much a comment on cinema - and on other forms of contemporary art - as it is an experience in its own right, but it is no less gripping for that. Its relentless action sequences demand attention whilst a vibrant score and well placed moments of humour keep the mood surprisingly upbeat. It's an adrenaline-fuelled adventure wrapped around an equally fierce political core, and despite her transformations it's the character of Mitsuko who makes it matter. Sono's work may lack subtlety but sometimes shouting from the rooftops is exactly what's needed, and he does it with style.