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By Oliver Sacks

The numerous manifestations of migraine can fluctuate dramatically from one sufferer to a different, even in the comparable sufferer at diversified instances. one of the such a lot compelling and complicated of those signs are the unusual visible hallucinations and distortions of area, time, and physique snapshot which migraineurs occasionally adventure. Portrayals of those uncanny states have came upon their means into many artworks, from the heavenly visions of Hildegard von Bingen to Alice in Wonderland. Dr. Oliver Sacks argues that migraine can't be understood easily as an disorder, yet needs to be considered as a posh with a special position to play in each one individual's existence.

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There's confident (paraesthetic) or unfavourable (anaesthetic) hallucinations. The paraesthesiae have a attribute exciting or vibrato of an analogous frequency because the visible scintillations. Tactile hallucinations could coexist with scotomata, precede them, persist with them, or happen of their absence, even though they're substantially much less universal than the visible manifestations. there isn't any fidelity during this, even in repeated assaults within the similar sufferer. They most ordinarily announce their visual appeal within the so much excitable and massively-represented parts of the tactile field—about the tongue and mouth, within the hand or fingers, and no more ordinarily within the feet—as the scotomata frequently seem with regards to the macula or maculae of the visual view. Very sometimes they could commence at the trunk, the thigh, or different parts of the tactile box. gentle or fleeting paraesthesiae might stay at their aspect of beginning; probably they unfold centripetally, from the distal to the proximal parts of the limbs. it truly is fullyyt valid, accordingly, to check them to the Jacksonian march of an epileptic air of mystery, if we have in mind very important alterations. The centripetal passage of migraine paraesthesiae, like that of the scintillating scotomata, is way slower than the corresponding passage of epileptic paraesthesiae—a unmarried “sweep” of the migraine charisma occupies 20 to half-hour. Recurrent cycles of paraesthesiae may well stick to each other for hours on finish, or trade with cycles of scotomata, in a migraine “status. ” Secondly, in contradistinction to epileptic auras which commence unilaterally within the overwhelming majority of situations, the paraesthesiae of migraine charisma commence bilaterally, or develop into bilateral, in additional than half all situations. Bilaterality is very universal with paraesthesiae of the lips and tongue. certainly, one may fit as far as announcing that if a competent witness insists that his or her charisma signs have by no means departed from one or different aspect, the prognosis of migraine needs to itself be seemed with a few suspicion (vide Case 26). Migrainous paraesthesiae could unfold in methods, both through direct extension to contiguous parts of the body-surface (tactile field), or via the inauguration of latest, separate foci in different places within the tactile box. different SENSORY HALLUCINATIONS Hallucinations of the opposite certain senses are unusual in migraine air of secrecy, even supposing I may still pass judgement on them to be particularly commoner than so much bills let for. Auditory hallucinations often take the shape of hissing, growling, or rumbling noises, that may be succeeded or preceded by means of dullness or lack of listening to. Hallucinations of scent were defined to me by way of numerous sufferers: the odor is generally severe, unpleasing, surprisingly normal but unspecifiable, and infrequently linked to compelled memory and emotions of déjà vu—symptoms similar to these taking place in uncinate seizures. Hallucinations of flavor are might be the least universal of the distinctive experience hallucinations. a number of visceral and epigastric signs might take place in the course of migraine air of secrecy.

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