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Overview
From the renowned neurologist and bestselling author of Awakenings and The Man Who Mistook His Wife for a Hat comes a fascinating investigation of the many manifestations of migraine, including the visual hallucinations and distortions of space, time, and body image which migraineurs can experience.
“So erudite, so gracefully written, that even those people fortunate enough never to have had a migraine in their lives should find it equally compelling.” —The New York Times
The many manifestations of migraine can vary dramatically from one patient to another, even within the same patient at different times. Among the most compelling and perplexing of these symptoms are the strange visual hallucinations and distortions of space, time, and body image which migraineurs sometimes experience. Portrayals of these uncanny states have found their way into many works of art, from the heavenly visions of Hildegard von Bingen to Alice in Wonderland. Dr. Oliver Sacks argues that migraine cannot be understood simply as an illness, but must be viewed as a complex condition with a unique role to play in each individual's life.
“So erudite, so gracefully written, that even those people fortunate enough never to have had a migraine in their lives should find it equally compelling.” —The New York Times
The many manifestations of migraine can vary dramatically from one patient to another, even within the same patient at different times. Among the most compelling and perplexing of these symptoms are the strange visual hallucinations and distortions of space, time, and body image which migraineurs sometimes experience. Portrayals of these uncanny states have found their way into many works of art, from the heavenly visions of Hildegard von Bingen to Alice in Wonderland. Dr. Oliver Sacks argues that migraine cannot be understood simply as an illness, but must be viewed as a complex condition with a unique role to play in each individual's life.
Product Details
| ISBN-13: | 9780375704062 |
|---|---|
| Publisher: | Knopf Doubleday Publishing Group |
| Publication date: | 10/05/1999 |
| Edition description: | Revised and Expanded |
| Pages: | 368 |
| Sales rank: | 159,855 |
| Product dimensions: | 5.28(w) x 7.98(h) x 0.76(d) |
About the Author
OLIVER SACKS was a neurologist, writer, and professor of medicine. Born in London in 1933, he moved to New York City in 1965, where he launched his medical career and began writing case studies of his patients. Called the “poet laureate of medicine” by The New York Times, Sacks is the author of thirteen books, including The Man Who Mistook His Wife for a Hat, Musicophilia, and Awakenings, which inspired an Oscar-nominated film and a play by Harold Pinter. He was the recipient of many awards and honorary degrees, and was made a Commander of the British Empire in 2008 for services to medicine. He died in 2015.
Hometown:
New York, New YorkDate of Birth:
1933Place of Birth:
London, EnglandEducation:
B.M., B.Ch., Queen's College, Oxford, 1958Table of Contents
| List of Illustrations | xiii | |
| Preface to the Revised (1992) Edition | xv | |
| Preface to the Original (1970) Edition | xvii | |
| Acknowledgments | xix | |
| Foreword | xxi | |
| Historical Introduction | 1 | |
| Part I | The Experience of Migraine | |
| Introduction | 11 | |
| Chapter 1 | Common Migraine | 13 |
| Introductory Comments | ||
| Headache | ||
| Nausea and Associated Symptoms | ||
| Facial Appearance | ||
| Ocular Symptoms | ||
| Nasal Symptoms | ||
| Abdominal Symptoms and Abnormal Bowel-Action | ||
| Lethargy and Drowsiness | ||
| Dizziness, Vertigo, Faintness and Syncope | ||
| Alterations of Fluid Balance | ||
| Fever | ||
| Minor Symptoms and Signs: Pupillary Abnormalities, Horner's Syndrome, Bradycardia, Multiple Ecchymoses, Whitening of Hair, etc. | ||
| Organic Irritability and Photophobia | ||
| Mood-Changes | ||
| Symptom-Constellations in Common Migraine | ||
| The Sequence of a Common Migraine: Prodromal Symptoms, Modes of Resolution, Post-Migrainous Rebound | ||
| Concluding Comments | ||
| Postscript (1992) | ||
| Chapter 2 | Migraine Equivalents | 34 |
| Introductory Comments | ||
| Cyclic Vomiting and Bilious Attacks | ||
| Abdominal Migraine | ||
| Periodic Diarrhoea | ||
| Periodic Fever | ||
| Precordial Migraine | ||
| Periodic Sleep and Trance-States | ||
| Periodic Mood-Changes | ||
| Menstrual Syndromes | ||
| Alternations and Transformations of Migraine | ||
| Borderlands of Migraine: Vagal Attacks, Faints, Reactions to Heat, Exhaustion, Passive Motion, Alcohol, etc. | ||
| Alternations and Concomitances with other Disorders: Asthma, Angina, Laryngospasm, Sleep-Disorders, Peptic Ulcer, Ulcerative Colitis, Crohn's Disease, Psoriasis, etc. | ||
| Differential Diagnosis of Migraine Equivalents | ||
| Concluding Comments | ||
| Chapter 3 | Migraine Aura and Classical Migraine | 51 |
| Introductory Comments: Historical Descriptions of Migraine Aura | ||
| Specific Visual Hallucinations: Phosphenes and Elementary Hallucinations, Varieties of Migraine Spectra, Characteristics of Scintillating and Negative Scotomata | ||
| Specific Tactile Hallucinations: Paraesthesiae, Anaesthesia | ||
| Other Sensory Hallucinations: Auditory, Olfactory, Taste, Epigastric, Motor, Vertiginous, etc. | ||
| Pseudo-objectivity of Migraine Hallucinations | ||
| General Alterations of Sensory Threshold | ||
| Alterations of Consciousness and Postural Tone | ||
| Specific Motor Disorders: Weakness, Paralyses, Spasms, Seizures | ||
| Alterations of Affect and Mood | ||
| Disorders of Higher Integrative Functions: Complex Visual Distortions (Micropsia and Macropsia, Mosaic and Cinematographic Vision, Metamorphopsias, Visual Agnosias, etc.) | ||
| Complex Apraxias, Agnosias, and Distortions of Body-Image | ||
| Aphasias | ||
| Time-Distortions, Deja Vu, and Forced Reminiscence | ||
| Dreamy States | ||
| Migrainous Deliria and Psychoses | ||
| Illustrative Case-Histories | ||
| Comments on the General Structure of Migraine Aura: Its Differential Diagnosis and Distinction from Epilepsies | ||
| Classical Migraine | ||
| Postscript (1992): The Angst of Scotoma | ||
| Chapter 4 | Migrainous Neuralgia ("Cluster Headache")--Hemiplegic Migraine--Ophthalmoplegic Migraine--Pseudo-Migraine | 99 |
| Migrainous Neuralgia: Synonyms, Typical Features, Illustrative Case-Histories | ||
| Hemiplegic and Facioplegic Migraine: Typical Features, Possible Mechanisms of Attack, Case-Histories | ||
| Ophthalmoplegic Migraine | ||
| Pseudo-Migraine: Organic Lesions Simulating Migraine | ||
| Permanent Neurological or Vascular Damage from Migraine | ||
| Chapter 5 | The Structure of Migraine | 109 |
| Introductory Comments, Components and Functional Levels of Migraine, Psychophysiological Stages of Migraine, General Characteristics of Migraine: Relation to Sleep, Epilepsy, etc. | ||
| Part II | The Occurrence of Migraine | |
| Introduction | 117 | |
| Chapter 6 | The Predisposition to Migraine | 119 |
| Introductory Comments | ||
| Overall Incidence of Migraine | ||
| Familial Occurrence and Inheritance of Migraine | ||
| Signs of Migrainous Constitution | ||
| Migraine Diathesis in Relation to Other Disorders | ||
| Migraine in Relation to Age | ||
| General Discussion and Conclusions | ||
| Chapter 7 | Periodic and Paroxysmal Migraines | 133 |
| Migraine and Other Biological Cycles | ||
| Time Between Attacks: Relation Between Frequency and Severity of Attacks | ||
| Immunity Between Attacks | ||
| Signs of Approaching Attacks | ||
| Intrinsic and Extrinsic Determinants of Periodicity | ||
| Conclusions: The Notion of Idiopathy | ||
| Postscript (1992) | ||
| Chapter 8 | Circumstantial Migraine | 140 |
| Classification of Provocative Circumstances | ||
| Arousal Migraines: In Response to Light, Noise, Odours, Weather, Exercise, Excitement, Violent Emotions, Pain, Drugs, etc. | ||
| Slump Migraines: In Relation to Eating, Fasting, Heat, Fever, Passive Motion, Exhaustion, Drugs (Alcohol, Reserpine, etc.) | ||
| Nocturnal Migraines, and Relation of Attacks to Dreams and Nightmares | ||
| Migraine Aura in Response to Flickering Light, Patterned Stimuli, and Visualisation of Scotomata | ||
| Miscellaneous Determinants: Food, Constipation, Menstrual Cycles, Hormones, Allergies, etc. | ||
| Self-Perpetuation of Migraines | ||
| Provocation of Attacks in Relation to "Tuning" and Homeostatic Limits Within Nervous System | ||
| Chapter 9 | Situational Migraine | 164 |
| Migraine in Relation to Intolerable Emotional Stress | ||
| Preliminary Comments on "Migraine Personality" and Relation of Attacks to Repressed Hostility | ||
| Case-Histories Illustrating Wide Range of Situations and Character-Types in which Repeated Migraines May Occur | ||
| Part III | The Basis of Migraine | |
| Introduction | 175 | |
| Clarification of the Term "Cause" in Relation to Migraine | ||
| Necessity to View Migraine in Three Ways: as a Process in the Nervous System, as a Reaction to Certain Stimuli, and as a Particular Form of Experience | ||
| Chapter 10 | Physiological Mechanisms of Migraine | 178 |
| Historical Introduction: Classical Theories (Humoral and Sympathetic), Vascular and Vasomotor Theories of the Nineteenth Century | ||
| Critiques of These | ||
| Liveing's Theory of "Nerve Storms" | ||
| Current theories of Migraine Mechanisms and their Supporting Data | ||
| Vasomotor Theories (Latham-Wolff) Considered and Disputed | ||
| Chemical Theories of Migraine, with Particular Reference to Acetylcholine, Histamine, and Serotonin: Critique of These | ||
| Electroencephalographic Findings in Migraine: Notion of "Dysrhythmic Migraine," and of "Spreading Depression" in Relation to Migraine | ||
| Limitations of Current Theory and Data | ||
| Chapter 11 | The Physiological Organisation of Migraines | 193 |
| Introductory Comments | ||
| Migraines as Polymorphous Parasympathetic or Trophotropic Events | ||
| Migraine as a Slow Form of Centrencephalic Seizure | ||
| Consideration of Visual Hallucinations in Migraine and Their Cortical Basis | ||
| Hierarchical Organisation of Migraines, and Their Relationship to other Paroxysmal Events | ||
| Migraine Considered as a "Neural Task," with Fixed Ends and Variable Means | ||
| Chapter 12 | Biological Approaches to Migraine | 205 |
| Migraine Considered as a Special Form of Protective Behaviour | ||
| Its Affinities to other Passive Reactions to Threat (Passive Fear, "Freezing," Sham Death, Pathological Sleep, Fainting, etc.) | ||
| Contrast of These Reactions to Fight-Flight Responses | ||
| Concept of the Migraine Archetype, and its Differentiation in Response to Human Needs and Human Nervous Systems | ||
| Chapter 13 | Psychological Approaches to Migraine | 211 |
| Necessity of Considering Migraines as Experiences to which Emotional Values are Attached. Common Uses of Migraines: Recuperative, Regressive, Encapsulative, Dissociative, Aggressive, and Self-Punitive Attacks | ||
| Mechanisms of Psychosomatic Illness in Reference to Migraine | ||
| Migraine Considered as a "Vegetative Neurosis" and as a Special Form of Conversion Reaction | ||
| Attachment of Symbolic Value to Particular Symptoms of Migraine | ||
| Migraine Considered as an Archaic Form of Bodily Language | ||
| Conclusions | ||
| Part IV | Therapeutic Approaches to Migraine | |
| Introduction | 229 | |
| Chapter 14 | General Measures in the Management of Migraine | 230 |
| Introductory Comments: Approach to the Patient and Role of the Physician | ||
| General Health Measures and Avoidance of Provocative Circumstances | ||
| Forms and Uses of Psychotherapy | ||
| Definition of Therapeutic Goals | ||
| Reasons for Success and Failure in the Treatment of Migraine | ||
| Chapter 15 | Specific Measures During and Between Attacks | 238 |
| Introductory and Historical Comments | ||
| Drugs of Specific Use During Acute Attacks: Ergotamine, its Uses and Contraindications, Caffeine, Parasympathetic Blockers (Belladonna, etc.), Sympathomimetic Drugs (Amphetamines, etc.) | ||
| Symptomatic Drugs: Analgesics, Anti-Emetics, etc. | ||
| Miscellaneous Drugs: Legitimate and Otherwise General Measures in the Acute Attack | ||
| Management of "Status Migrainosus" | ||
| Drugs Employed in the Prevention of Migraine Attacks: Methysergide (Sansert, Deseril), its Uses and Dangers | ||
| Use of Ergotamine Prophylactically | ||
| The Role of Sedatives, Tranquillisers, Anti-Depressants, etc. | ||
| Other Forms of Medication | ||
| The Uses of Placebos | ||
| Histamine "Desensitisation" | ||
| Allergic "Desensitisation" | ||
| Hormone Preparations, Their Abuses and Dangers | ||
| The Place of Surgical Procedures | ||
| Conclusions | ||
| Chapter 16 | Recent Advances in the Treatment of Migraine | 256 |
| Part V | Migraine as a Universal | |
| Chapter 17 | Migraine Aura and Hallucinatory Constants (with Ralph M. Siegel, PH.D.) | 273 |
| Introduction | ||
| Types or Levels of Hallucination | ||
| Hallucinatory Constants | ||
| Mechanisms of Hallucination | ||
| Self-Organising Systems | ||
| A New Model of Migraine Aura | ||
| Appendix I | The Visions of Hildegard | 299 |
| Appendix II | Cardan's Visions (1570) | 302 |
| Appendix III | Remedies Advised by Willis (1672), Heberden (1801) and Gowers (1892) | 304 |
| Glossary of Case-Histories | 307 | |
| Glossary of Terms | 311 | |
| Bibliography | 319 | |
| Index | 329 |
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