{"id":6152,"date":"2025-05-20T23:37:05","date_gmt":"2025-05-20T23:37:05","guid":{"rendered":"https:\/\/tomeri.org\/notes\/?p=6152"},"modified":"2026-03-04T23:39:06","modified_gmt":"2026-03-04T23:39:06","slug":"migraine-oliver-sacks","status":"publish","type":"post","link":"https:\/\/tomeri.org\/notes\/2025\/05\/20\/migraine-oliver-sacks\/","title":{"rendered":"Migraine*, Oliver Sacks"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">*<em>Migraine <\/em>(Revised and expanded), Oliver Sacks, 1992<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This is the 18th volume in the &#8220;Essays Project.&#8221;  While the Essays Project has focused mainly on essays, we became intrigued with Oliver Sacks and are taking something of a detour to read his complete work, essays or not. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">[[More to come&#8230;]]<\/p>\n\n\n\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_85 counter-hierarchy ez-toc-counter ez-toc-light-blue ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/tomeri.org\/notes\/2025\/05\/20\/migraine-oliver-sacks\/#Front_Matter\" >Front Matter<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/tomeri.org\/notes\/2025\/05\/20\/migraine-oliver-sacks\/#I_The_Experience_of_Migraine\" >I. The Experience of Migraine<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/tomeri.org\/notes\/2025\/05\/20\/migraine-oliver-sacks\/#C1_The_Common_Migraine\" >C1. The Common Migraine<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/tomeri.org\/notes\/2025\/05\/20\/migraine-oliver-sacks\/#II_The_Occurrence_of_Migraine\" >II. The Occurrence of Migraine<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/tomeri.org\/notes\/2025\/05\/20\/migraine-oliver-sacks\/#III_The_Basis_of_Migraine\" >III. The Basis of Migraine<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/tomeri.org\/notes\/2025\/05\/20\/migraine-oliver-sacks\/#IV_Therapeutic_Approaches_to_Migraine\" >IV: Therapeutic Approaches to Migraine<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/tomeri.org\/notes\/2025\/05\/20\/migraine-oliver-sacks\/#V_Migraine_as_a_Universal\" >V: Migraine as a Universal<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/tomeri.org\/notes\/2025\/05\/20\/migraine-oliver-sacks\/#i\" ># # #<\/a><\/li><\/ul><\/nav><\/div>\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Front_Matter\"><\/span>Front Matter<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">There are prefaces to the original edition, and, to this, the 1992 edition. There is also a forward by William Gooddy, a migraine specialist whom Sacks praises in his prefaces. There is also a historical introduction, which summarizes over 2,000 years of medical writing on migraine; I will pass on summarizing this. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The following, from the &#8217;92 Preface,  is Sacks&#8217; comment on the aims of the book; I think his thoughts on why humans may need to be ill, for a brief time, will be very interesting.<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p class=\"wp-block-paragraph\">Migraine, of course, is not just a description, but a meditation on the nature of health and illness, and how, occasionally, human beings may need, for a brief time, to be ill; a meditation on the unity of mind and body, on migraine as an exemplar of our psychophysical transparency; and a meditation, finally, on migraine as a biological reaction, analogous to that which many animals show.<br><br>\u2013Oliver Sacks, Migraine, xv<\/p>\n<\/blockquote>\n\n\n\n<!--more-->\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"I_The_Experience_of_Migraine\"><\/span>I. The Experience of Migraine<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"C1_The_Common_Migraine\"><\/span>C1. The Common Migraine<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">As I read through this chapter, the vast range of symptoms and manifestations attributed to Migraine would seem to defy any sort of classification. However, Sacks grapples with this by describing constellations of symptoms, and also sequences of symptoms\/constellations, and leaves me with the sense that Migraine really is a distinct and identifiable entity. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One thing which I think, perhaps, he does not emphasize enough is that migraine recurs over the course of months and years, and I think that it is this pattern of recurrence (even though the symptoms may change completely) that I find most convincing. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Sacks&#8217; high level description is that there is a prodomal phase  (when the first hints of what is coming occur), the attack proper, resolution, and finally rebound. I&#8217;m particularly struck by the fact that both prodomal and rebound phases may often (but not invariably) include feelings of great well-being. <\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"II_The_Occurrence_of_Migraine\"><\/span>II. The Occurrence of Migraine<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This section examines when migraines occur, and divides them into <strong>periodic<\/strong> (occurring a particular times and with particular rhythms of occurrence), <strong>circumstantial<\/strong> (appearing in response to particular circumstances), and <strong>situational<\/strong> (as a reaction to intolerable situations such as stress). <\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"III_The_Basis_of_Migraine\"><\/span>III. The Basis of Migraine<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">We skimmed this section, except for focusing on the psychological causes of migraine. <\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"IV_Therapeutic_Approaches_to_Migraine\"><\/span>IV: Therapeutic Approaches to Migraine<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">We only skimmed this section. As the title suggests, it has to do with approaches to avoiding, ameliorating or otherwise treating migraines. <\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"V_Migraine_as_a_Universal\"><\/span>V: Migraine as a Universal<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This section is really just one chapter which is on Migraine Aura and Hallucinatory Constants. It discusses, and tries to systematize the types of hallucinations seen during the migraine aura phase. There are three types: <strong>phosphenes<\/strong> (stars and scintillating points of light); <strong>spectra<\/strong>: the classical expanding scotoma with its &#8216;fortification edges&#8217;; <strong>dynamic geometric pattern<\/strong>s (grids, mosaics, spirals, etc.)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The interesting thing about these hallucinatory phenomena is the possibility that they are a direct reflection of activity and function of cortical cells. For example, the &#8216;fortifications&#8217; around the edge of a scotoma may (perhaps) be produced by groups of edge\/orientation detecting cells. Similarly, Alan Turing described how waves of chemical reactions can give rise to regular geometric patterns in &#8220;<a href=\"http:\/\/www.dna.caltech.edu\/courses\/cs191\/paperscs191\/turing.pdf\">The Chemical Basis of Morphogenesis<\/a>.&#8221;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Another thing this brought to mind was John Conway&#8217;s Game of Life, in which 2D cellular automata with simple rules can produced spreading and repeating patterns of activity. See <a href=\"https:\/\/en.wikipedia.org\/wiki\/Conway's_Game_of_Life\">the wikipedia article<\/a>. One wonders if the cortex, when undergoing a migraine, can generate such spreading and repeating patterns. <\/p>\n\n\n\n<h1 class=\"wp-block-heading has-text-align-center\"><span class=\"ez-toc-section\" id=\"i\"><\/span># # #<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<p>Views: 25<\/p>","protected":false},"excerpt":{"rendered":"<p>*Migraine (Revised and expanded), Oliver Sacks, 1992 This is the 18th volume in the &#8220;Essays Project.&#8221; While the Essays Project has focused mainly on essays, we became intrigued with Oliver Sacks and are taking something of a detour to read his complete work, essays or not. [[More to come&#8230;]] Front Matter There are prefaces to &hellip; <a href=\"https:\/\/tomeri.org\/notes\/2025\/05\/20\/migraine-oliver-sacks\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Migraine*, Oliver Sacks<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":6182,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"activitypub_content_warning":"","activitypub_content_visibility":"","activitypub_max_image_attachments":4,"activitypub_interaction_policy_quote":"anyone","activitypub_status":"federated","footnotes":""},"categories":[36,75,78,71],"tags":[],"class_list":["post-6152","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-book-notes","category-more-to-be-added","category-now-reading","category-oliver-sacks"],"_links":{"self":[{"href":"https:\/\/tomeri.org\/notes\/wp-json\/wp\/v2\/posts\/6152","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tomeri.org\/notes\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tomeri.org\/notes\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tomeri.org\/notes\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/tomeri.org\/notes\/wp-json\/wp\/v2\/comments?post=6152"}],"version-history":[{"count":12,"href":"https:\/\/tomeri.org\/notes\/wp-json\/wp\/v2\/posts\/6152\/revisions"}],"predecessor-version":[{"id":8799,"href":"https:\/\/tomeri.org\/notes\/wp-json\/wp\/v2\/posts\/6152\/revisions\/8799"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tomeri.org\/notes\/wp-json\/wp\/v2\/media\/6182"}],"wp:attachment":[{"href":"https:\/\/tomeri.org\/notes\/wp-json\/wp\/v2\/media?parent=6152"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tomeri.org\/notes\/wp-json\/wp\/v2\/categories?post=6152"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tomeri.org\/notes\/wp-json\/wp\/v2\/tags?post=6152"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}