| Oliver Sacks; Migraine | |||||
| Book | Page | Topic | |||
| Sacks; Migraine | 11 | Headache is never the sole symptom of a migraine, nor is it a necessary feature of migraine attacks. | |||
| Sacks; Migraine | 11 | Migraine equivalents -- nausea and vomiting, abdominal pain, diarrhea, fever, drowsiness, mood changes, etc. | 0 | ||
| Sacks; Migraine | 11 | Migraine aura may occur as isolated events. | 0 | ||
| Sacks; Migraine | 13 | Cardinal symptoms of common migraine are a headache and nausea. | 2 | ||
| Sacks; Migraine | 14 | Migraine headache is traditionally described as a violent throbbing pain in one temple. | 1 | ||
| Sacks; Migraine | 15 | Migraine headache is variable. Throbbing occurs in less than half of all cases. | 1 | ||
| Sacks; Migraine | 34 | Migraine equivalents -- a migraine is an aggregate of innumerable components, and its structure is composite. | 19 | ||
| Sacks; Migraine | 45 | Many migraine patients are highly intolerant of alcohol. | 11 | ||
| Sacks; Migraine | 51 | A classical migraine is a migraine with aura. | 6 | ||
| Sacks; Migraine | 52 | The term aura has been used for nearly 2000 years to denote the sensory hallucinations immediately preceding certain epileptic seizures. | 1 | ||
| Sacks; Migraine | 53 | Manifestations of the migraine aura are exceedingly various, and include not only simple and complex sensory hallucinations, but intense affective states, deficits and disturbances of speech and ideation, dislocations of time and space perception, and a variety of dreamy, delirious, and trancelike states. | 1 | ||
| Sacks; Migraine | 53 | Phosphenes -- the simplest hallucination takes the form of a dance of brilliant stars, sparks, flashes or simple geometric forms across the visual field. | 0 | ||
| Sacks; Migraine | 57 | Majority of migraine scotoma present as a sudden brilliant luminosity near the fixation point in one visual half-field; from here the scotoma gradually expands and moves slowly towards the edge of the visual field, assuming the form of a giant crescent or horseshoe. | 4 | ||
| Sacks; Migraine | 58 | Variants of migraine scotoma. (picture) | 1 | ||
| Sacks; Migraine | 59 | The advancing margin of the scotoma often displays the gross zigzag appearance which justifies the term fortification spectrum and is invariably broken up, more finely, into minute luminous angles and intersecting lines. | 1 | ||
| Sacks; Migraine | 59 | There is a characteristic scintillation throughout the luminous portion of the scotoma. | 0 | ||
| Sacks; Migraine | 59 | Rate of oscillation of the scotoma is below the flicker- fusion frequency, yet too fast to count; it's frequency has been estimated as lying between 8 and 12 oscillations per second. | 0 | ||
| Sacks; Migraine | 59 | Margin of the scintillating scotoma advances at a rather constant rate, and usually takes between 10 and 20 minutes to pass from the neighborhood of the fixation point to the edge of the visual field. | 0 | ||
| Sacks; Migraine | 59 | When the scotoma is over, the headache comes on. | 0 | ||
| Sacks; Migraine | 62 | Structure of a scintillating scotoma (sketch) | 3 | ||
| Sacks; Migraine | 63 | Course and structure of a scintillating scotoma. Lashley (1941) | 1 | ||
| Sacks; Migraine | 72 | Migraine alterations of the highest integrated function. | 9 | ||
| Sacks; Migraine | 73 | Complex disorders of visual perception, cinematographic vision. | 1 | ||
| Sacks; Migraine | 73 | Entire gamut of speech and language disorders. | 0 | ||
| Sacks; Migraine | 73 | Disorders and dislocations of time perception. | 0 | ||
| Sacks; Migraine | 73 | Elaborate dreamy, nightmarish, trance-like or delirious states. | 0 | ||
| Sacks; Migraine | 74 | Scintillation rate of migrainous scotomata (six to 12 per second). | 1 | ||
| Sacks; Migraine | 75 | Phenomena of mosaic and cinematic vision are of extreme importance. They show us how the brain-mind constructs "space" and "time", by demonstrating what happens when space and time are broken. | 1 | ||
| Sacks; Migraine | 78 | One of the wonders of opium is to transform instantaneously an unknown room into a room so familiar, so full of memories. | 3 | ||
| Sacks; Migraine | 79 | Intense, involuntary daydreams or daymares. | 1 | ||
| Sacks; Migraine | 81 | Migraine severe enough to warrant hospital admission. | 2 | ||
| Sacks; Migraine | 81 | Sense-of-self appears to be based, fundamentally, on a continuous inference from the stability of body image, the stability of outward perceptions, and the stability of time perception. | 0 | ||
| Sacks; Migraine | 87 | Structure of the migraine aura. | 6 | ||
| Sacks; Migraine | 88 | Incidence of classical migraine is less than 1% in the general population. | 1 | ||
| Sacks; Migraine | 88 | Incidence of migraine aura is suspected to be far in excess of the quoted incidence of classical migraine. | 0 | ||
| Sacks; Migraine | 89 | Differential diagnosis of migraine aura -- migraine versus epilepsy. | 1 | ||
| Sacks; Migraine | 89 | Visual symptoms are far commoner in migraine than in epilepsy, and often assume a very specific form -- scintillating and negative scotomata -- not seen an epileptic auras. | 0 | ||
| Sacks; Migraine | 90 | Convulsions are common and epilepsy. | 1 | ||
| Sacks; Migraine | 90 | Loss of consciousness is common in epilepsy. | 0 | ||
| Sacks; Migraine | 90 | Abrupt onset in epilepsy, but gradual onset in migraine. | 0 | ||
| Sacks; Migraine | 91 | grand mal convulsion | 1 | ||
| Sacks; Migraine | 96 | Word scotoma means darkness or shadow. | 5 | ||
| Sacks; Migraine | 97 | Neuropsychological concepts of consciousness provided by Gerald Edelman. | 1 | ||
| Sacks; Migraine | 98 | Edelman sees consciousness arising from a perceptual integration, coupled with the sense of historical continuity, a continuous relating of past and present. | 1 | ||
| Sacks; Migraine | 98 | Profound alterations of self and consciousness only last for a few minutes in migraine. | 0 | ||
| Sacks; Migraine | 98 | Our highest functions -- consciousness and self -- are not entities, self-sufficient, "above" the body, but neuropsychological constructs -- processes dependent on the continuity of bodily experience and its integration. | 0 | ||
| Sacks; Migraine | 122 | Migraine tends to be commoner in certain families. | 24 | ||
| Sacks; Migraine | 127 | Late-onset migraines. | 5 | ||
| Sacks; Migraine | 140 | Circumstantial migraine | 13 | ||
| Sacks; Migraine | 141 | Flickering light as a highly specific provocative circumstance. | 1 | ||
| Sacks; Migraine | 149 | Flickering light from any source may elicit the immediate appearance of the scintillating scotoma with a scintillation rate identical with the frequency of the provocative stimulus. | 8 | ||
| Sacks; Migraine | 149 | Stroboscopic experiments demonstrate that only flicker frequencies in a narrow band (between 8 and 12 stimuli per second) are affective in provoking the scintillating scotoma. | 0 | ||
| Sacks; Migraine | 150 | We are forced to seek an explanation of two facts -- the immediacy of the scotomatic response, and it's numerically precise synchronization with flicker stimulus. The most economical conjecture is that such phenomena are due to a quantitative attunement, or resonance within the nervous system, following the impact of appropriate stimuli. | 1 | ||
| Sacks; Migraine | 150 | Intolerance of noise (phonophobia) is an almost universal feature of the irritability characteristics of many migraines. | 0 | ||
| Sacks; Migraine | 150 | Particular aggravating, or provocative power of sounds of certain frequencies. | 0 | ||
| Sacks; Migraine | 150 | Some migraine patients are immediately affected by the sound of pneumatic drills. The repetitive chattering of these drills is particularly provocative of migraines, not just their intensity, but the chatter of their noise. | 0 | ||
| Sacks; Migraine | 151 | Combination of high intensity with insistent repetition makes the beat of loud rock music migraineogenic to some patients, a phenomenon analogous to musicogenic epilepsy. | 1 | ||
| Sacks; Migraine | 151 | It is not the intensity of the sound nor some particular timber, but specifically its frequency that is intolerable. | 0 | ||
| Sacks; Migraine | 151 | It is only particular frequencies of flashing light or banging noise which cause gross disturbance in the brain wave patterns, in synchrony with the stimulus, that kindle a severe, paroxysmal cerebral response. | 0 | ||
| Sacks; Migraine | 151 | In striking contrast, pleasant, melodious and truly musical stimuli rapidly restore constancy and rhythmicity to the brain waves, and can terminate the paroxysmal response, both clinically and electrically. | 0 | ||
| Sacks; Migraine | 151 | The right sound -- proper music -- is truly tranquilizing, and immediately restore cerebral health. | 0 | ||
| Sacks; Migraine | 151 | Migraines can be evoked by unusual rhythms and disturbances in time. | 0 | ||
| Sacks; Migraine | 180 | The notion of a vasoconstrictor origin of the migraine process is still widely and uncritically held today. | 29 | ||
| Sacks; Migraine | 182 | Migraine arises in the central nervous system. | 2 | ||
| Sacks; Migraine | 182 | The central nervous system is electrochemical machine nourished by blood. | 0 | ||
| Sacks; Migraine | 182 | Explanations of migraine concern themselves with: (1) nourishment of the nervous system (vasomotor theories), (2) chemistry of the nervous system, (3) electrical activity of the nervous system | 0 | ||
| Sacks; Migraine | 189 | Studies have failed to uncover any clear and consistent EEG abnormality peculiar to migraine. | 7 | ||
| Sacks; Migraine | 189 | It has been impossible to define any EEG abnormalities which bears a specific relation to migraine, as wave-and-spike patterns do to epilepsy. | 0 | ||
| Sacks; Migraine | 189 | There have been exceedingly few EEG recordings obtained during the actual occurrence of migraine auras. | 0 | ||
| Sacks; Migraine | 189 | Volumes of information we have concerning epilepsy. | 0 | ||
| Sacks; Migraine | 189 | There is no reliable method of eliciting a migraine aura, in contrast to the ease of provoking epileptic seizure activity. | 0 | ||
| Sacks; Migraine | 189 | Migrainoid reactions induced by reserpine have no aura component. | 0 | ||
| Sacks; Migraine | 189 | Researchers cannot record from the exposed brain or use deep electrodes, as is justified in many cases of epileptic seizure disorder. | 0 | ||
| Sacks; Migraine | 189 | Researches cannot identify migraine or any migraine-like process in animals. | 0 | ||
| Sacks; Migraine | 190 | Migraine scotomata are estimated to move in a wave of excitation across the visual cortex at a rate of about 3 mm per minute. | 1 | ||
| Sacks; Migraine | 190 | Migraine involves widespread alteration of cortical function rather than any local process, ischemic or depressive. | 0 | ||
| Sacks; Migraine | 190 | Deep in the brainstem is the origin of the migraine process, slow tonic changes of excitation and inhibition. | 0 | ||
| Sacks; Migraine | 191 | It seems impossible that the central symptoms of migraine aura could be explained by considerations of local cortical ischemia. | 1 | ||
| Sacks; Migraine | 191 | Vascular and humoral factors can have at most a partial significance in the pathogenesis of migraine. | 0 | ||
| Sacks; Migraine | 193 | There exist anatomically discrete ganglionic plexuses in all the major visceral, vascular, and glandular structures of the body. | 2 | ||
| Sacks; Migraine | 196 | Patterns and passage of the simplest migraine phosphenes across the visual field are reminiscent of the hallucinations of color and abstract form (flickering lights, stars, wheels, disks, whirling bands, etc.) | 3 | ||
| Sacks; Migraine | 196 | Format of the migraine scotomata is apparently unique to the migraine process. | 0 | ||
| Sacks; Migraine | 196 | Characteristic microstructure of the scotomata is related to the underlying cytoarchitectonic pattern, or neuronal grain, of the primary visual cortex. | 0 | ||
| Sacks; Migraine | 196 | Rate of spread of the migraine scotomata and the corresponding wave of excitation moves over the primary visual cortex at about 3 mm per minute. | 0 | ||
| Sacks; Migraine | 198 | Flicker rate of scotomata (6 to 12 per second). | 2 | ||
| Sacks; Migraine | 198 | Flicker rate of scotomata are the same frequency as the alpha rhythms, and of the frequency of stroboscopic illumination most prone to cause photic driving of the EEG, photo-epilepsy, and photo-scotomata. | 0 | ||
| Sacks; Migraine | 198 | We may suspect that this frequency of flicker rate of scotomata is related to a fixed and finite rate of perceptual elaboration or scanning. | 0 | ||
| Sacks; Migraine | 199 | Hierarchy of hallucinations in migraine auras is correlated with successive activations in different cortical fields. | 1 | ||
| Sacks; Migraine | 199 | Areas of cortex occupied by primary, secondary and tertiary fields, and their overlapping and abutment on one another. | 0 | ||
| Sacks; Migraine | 200 | Migraine auras so chiefly the symptoms of cortical involvement. | 1 | ||
| Sacks; Migraine | 205 | Laughing, frowning and sneering are exclusively found in humans. | 5 | ||
| Sacks; Migraine | 210 | The elaboration of the cortical mantle permits more numerous, more varied, and more easily-conditioned cerebral reflexes. | 5 | ||
| Sacks; Migraine | 210 | Hierarchically-ordered neuronal fields in the human cortex. | 0 | ||
| Sacks; Migraine | 210 | The most complex and distinctive feature of migraines, the aura. | 0 | ||
| Sacks; Migraine | 210 | The complexities of migraine aura are a byproduct of the unique differentiation of the human cortex, and could not conceivably occur in less complex nervous systems. | 0 | ||
| Sacks; Migraine | 210 | We may recognize the primordia of epilepsy and psychoses in more primitive mammals, but their most complex and individual characteristics -- hallucinatory and ideational disturbances -- as dependent on cortical development and differentiation, and above all the final elaboration of frontal and temporal lobes in humans. | 0 | ||
| Sacks; Migraine | 210 | We must see migraine as a most primitive and generalized form of adaptive reaction, which has been refined and differentiated by unique possibilities of human nervous systems. | 0 | ||
| Sacks; Migraine | 262 | Block the reuptake of serotonin. | 52 | ||
| Sacks; Migraine | 262 | Cannot treat patients by rote; no scheme or formula that fits every patient. | 0 | ||
| Sacks; Migraine | 262 | A patient and painstaking trial of every drug and every drug combination available, in hope of finding something which suits that individual. | 0 | ||
| Sacks; Migraine | 263 | Different families of serotoninergic receptors. | 1 | ||
| Sacks; Migraine | 263 | Drug L-DOPA for the treatment of Parkinson's disease -- so dramatic and fundamental in its effects as to transform the life of Parkinson patients. | 0 | ||
| Sacks; Migraine | 264 | The final common pathway of migraine, the abnormal firing of neurons in brainstem nuclei. | 1 | ||
| Sacks; Migraine | 264 | Holistic notions of stress reduction, relaxation, meditation, yoga; and to notions of self-help using the will or the mind, aided by the techniques of biofeedback. | 0 | ||
| Sacks; Migraine | 264 | Essence of biofeedback is to make some normally invisible physiological parameter strongly visible and present to consciousness, so that the will can comprehend, and hopefully change it. | 0 | ||
| Sacks; Migraine | 265 | The most obvious correlate of migraine headache is a pulsation of the frontal branches of superficial temporal arteries. | 1 | ||
| Sacks; Migraine | 266 | Yoga and transcendental meditation, which is little more than a self-hypnotizing mantra. | 1 | ||
| Sacks; Migraine | 266 | Immediate and total termination of a Tourette "fit" -- with violent tics, barking, cries, and jerks -- by self induced hypnosis | 0 | ||
| Sacks; Migraine | 273 | Visual disturbances of migraine are common -- they affect at least 10% of the population. | 7 | ||
| Sacks; Migraine | 273 | Migraine aura's most characteristic phenomenon, the expanding, scintillating, zigzag arc. | 0 | ||
| Sacks; Migraine | 274 | Kaleidoscopic power of the sensorium to form regular patterns by the symmetrical combination of casual elements. | 1 | ||
| Sacks; Migraine | 275 | In epilepsy there is less tendency to geometrical forms, but a much greater disposition to dramatic hallucinations of complex events and scenes. | 1 | ||
| Sacks; Migraine | 275 | The nimble epileptic aura lasts only a few seconds, whereas the slow excitations of migraine aura might continue for half an hour. | 0 | ||
| Sacks; Migraine | 276 | Migraine oral starts as a spot near the fixation point, and then moves outward across the visual field in the form of a giant crescent. | 1 | ||
| Sacks; Migraine | 276 | Advancing margin of a scotoma in its transit across the visual field takes about 20 minutes, and its rate of scintillation is about 10 per second. | 0 | ||
| Sacks; Migraine | 276 | Polygonal shapes -- squares, rhomboids, trapezoids, triangles, hexagons, or more complex shapes may dominate the scotoma. | 0 | ||
| Sacks; Migraine | 277 | Fortifications of scotoma are extremely brilliant -- comparable to a white service reflecting the noonday sun. | 1 | ||
| Sacks; Migraine | 278 | Polygons come together to form what patients variously compare to spiderwebs, honeycombs, mosaics, networks, lattices. | 1 | ||
| Sacks; Migraine | 279 | When the migraine aura is over, there may or may not be a headache. | 1 | ||
| Sacks; Migraine | 280 | The observing mind usually remains clear in a migraine, even in the stormiest migraine. | 1 | ||
| Sacks; Migraine | 280 | During a migraine aura, the mind remains able to attend and observe, to describe, to analyze, to depict, to remember. | 0 | ||
| Sacks; Migraine | 280 | geometrical forms very similar to what may be seen in migraine may also occur with various intoxications. | 0 | ||
| Sacks; Migraine | 285 | Simplest migraine hallucinations are phosphenes. | 5 | ||
| Sacks; Migraine | 285 | It seems probable that migraines began with internally-generated excitation of the visual cortex. | 0 | ||
| Sacks; Migraine | 286 | Scotoma always remains constant in form as it expands. | 1 | ||
| Sacks; Migraine | 286 | By plotting the rate of enlargement of the scotoma and comparing it with the known dimensions of the striate cortex he can calculate that the wave of excitation, from his first appearance near the macula, must then spread across the cortex at about 3 mm per minute. | 0 | ||
| Sacks; Migraine | 287 | Rate of scintillation (about 10 per second), and patterns of lines and angles seem to be about the same for everyone who experiences them. | 1 | ||
| Sacks; Migraine | 287 | Using techniques of magneto-encephalography, it has been confirmed that a slow wave of excitation and inhibition, slowly spreading across the striate cortex, may be visualized during the course of migraine auras. | 0 | ||
| Sacks; Migraine | 288 | During the 1960s, Hubel and Wiesel were able to demonstrate the existence of a variety of feature detectors within the visual cortex -- detectors which were organized into small "columns." | 1 | ||
| Sacks; Migraine | 288 | Advancing wave of the scotoma activates not individual columns, but groups or pools of them responding to the same orientation. | 0 | ||
| Sacks; Migraine | 288 | A wave of excitation advancing across the cortex, could throw one group after another of the columns into activity, causing the patient to see bars of light at different angles, shimmering as column after column is stimulated. | 0 | ||
| Sacks; Migraine | 288 | Migraine fortification aura is an excellent natural experiment -- the advancing waves of disturbance draw continuous traces across the cortex, and in less than half an hour, reveal part of the secret of its neuronal organization. | 0 | ||
| Sacks; Migraine | 289 | Propagation of complex waves in an excitable medium. | 1 | ||
| Sacks; Migraine | 289 | Complex systems and their self-organization in time -- nonlinear dynamical systems, chaos theory. | 0 | ||
| Sacks; Migraine | 291 | Complexity, self-organization, spontaneous emergence -- such systems tend to hover far from equilibrium, and it is this far-from-equilibrium position which gives them their sensitivity, their criticality, their capacity to change radically and unpredictably, to generate, to evolve, new structures and forms. | 2 | ||
| Sacks; Migraine | 292 | Chaos theory has provided a fundamental key to understanding complexity and irreversibility throughout the whole of nature. | 1 | ||
| Sacks; Migraine | 293 | Benoit Mandelbrot -- "Mandelbrot set" -- it is characteristic of natural forms that they exist simultaneously on many scales and preserve their forms, and are isomorphic, what ever the scale. | 1 | ||
| Sacks; Migraine | 293 | Cortex has 100 million cells, 20 cell types, six layers, and an infinity of connections both intrinsic and extrinsic. | 0 | ||
| Sacks; Migraine | 294 | Action potentials do not propagate instantly through a network, but take time to propagate through the axon and across the synapse. | 1 | ||
| Sacks; Migraine | 294 | All-or-none quality of action potentials. | 0 | ||
| Sacks; Migraine | 294 | Symmetrically spreading cortical waves which underlie the uniform enlargement of scotoma. | 0 | ||
| Sacks; Migraine | 295 | Emergence and evolution, quite spontaneously, of complex geometrical patterns in space and time. | 1 | ||
| Sacks; Migraine | 297 | Processes of chaos and self-organization in the cortex are normally local, microscopic, and individual -- it is only in pathological conditions that they cohere, synchronize, become global, become visible, take over, and thrust themselves as patterned hallucinations into awareness. | 2 | ||
| Sacks; Migraine | 297 | Migraine is enthralling; it shows us in the form of a hallucinatory display an entire self-organizing system. | 0 | ||