Oliver Sacks; Migraine
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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