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Visual hallucinations Visual hallucinations
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Author: Klaus Podoll 13. May 2007
Edited by: Klaus Podoll

Visual hallucinations

Delia Malchert, Animated fortification spectrum, 2002. © 2002 Delia Malchert

A migraine sufferer wrote: "Anyway, I had auras (i.e., flashes of light on the periphery of my eye and what looked like lightening bolts - jagged lines like 'Z's' ... ) ... I am told auras occur before a headache and ... that auras can also be considered hallucinations - visual hallucinations. I'm wondering if it is possible that this is what happened ... Has anyone experienced these and what do you think about the auras being hallucinations? They are real to me and I know they happened - I thought a hallucination was something you just thought happened but it didn't really. Sorry for my ignorance - this is all new to me."

(JHB, Newsgroups: alt.support.depression.manic, Subject: Auras/hallucination?, May 2, 1999)

In general terms, a visual hallucination can be defined as a visual perception that is not associated with external visual stimuli - thus, the migraineur's recurring zigzagged auras qualify as visual hallucinations just as well as the geometric patterns experienced after psychedelic drug ingestion, to name only two of the many conditions under which such visual hallucinations may occur. It is important to grasp that speaking about a migraine sufferer having a visual hallucination doesn't mean saying she or he is insane, as misunderstood by many.

Had an aura migraine yesterday...

"And it scared the crap out of me... this was the second one I've had in my 53 years. The first was two Xmases ago... an old girlfriend from high school was in town and coming over to visit me so I was furiously doing some housecleaning... while bending over the bathroom sink, scrubbing it, the classic aura started... growing from a bright spinning wheel in the upper left corner of vision of my left eye, very slowly, into the classic sawtooth arc or wheel, which then rotated across my left field of vision, then into my right field..

I didn't have a clue what was going on. I sat down and tried to compose myself, wondering if I was going blind. The sawtooth wheel was visible even when I turned off all the lights and covered my eyes as tightly as I could... I went into a complete panic. She came to the door just as it started to finish fading out (I had NEVER done any reading on aura migraines and had no idea that they typically last 15-20 minutes or so, as this one did)... I told her I thought maybe she'd have to drive me to a hospital. so we sat together for a while, and I could not get over this stupifying experience I had just gone through.

After half an hour, my vision was normal again. I did some reading, found a web page (which I cannot find now) that actually had an illustration of the imagery one sees in their mind's eye during an aura session.. the rotating sawtooth blade (any of you know the web site with that image on it, and can throw a URL at me, I'd really appreciate it [the image (see above) was displayed at the Headache Cybertext webpage from David C. Haas, available on the internet until his retirement in December 2004] ).. learned that it had nothing to do with my eyes, the images were not happening in my eyes, they were manifestations of what was happening in the cerebral cortex...

Okay, so, two years go by... So... yesterday morning, I'm sitting at the computer reading Usenet.. I had not yet taken the morning dose of the two bp pills... suddenly I notice a sparkling in my upper left corner field of vision which, you got it, grew into a full blown aura, the same arcing, slowly rotating sawtooth blade I saw for the first time two years ago... this time I didn't panic (quite as much) although I started to a lot of that 'God! Make it go away' type of praying (and I am not a religious person)... as I half-expected, 15-20 minutes later, the visual disturbances, after growing and slowly moving across the field of vision of both eyes, slowly faded away, leaving me with a gray spot in my direct forward vision, and then 10 minutes later, that faded away and my vision returned to normal.

About half an hour later, I developed the headache, in the upper right quadrant of my head, and it lasted most of the rest of the day."

(Harv Laser, Newsgroups: alt.support.headaches.migraine, Subject: Had an Aura Migraine yesterday... comments appreciated..., December 16, 2002; additions in square brackets by Klaus Podoll)

Hubert Airy, Illustration of fortification spectrum (reproduced from Gowers, 1895)

The hallucinations of the migraine aura are experienced in full waking consciousness as vivid impressions that display, according to Gowers (1985), an involuntary sense of objectivity. Nevertheless, in spite of this pseudo-objectivity (Sacks, 1992) migraineurs almost always learn not to mistake these perceptual disturbances for reality. In childhood migraine with aura, however, it may not be uncommon for the affected boys or girls to behave in a way suggesting that the hallucinatory patterns are considered as enchanting or frightening (see here) "real" entities, as illustrated by the following childhood memories of an adult female migraineur.

Objectivity of migraine aura hallucinations experienced by a childhood migraine sufferer

"The most important question I wanted to ask was about auras, for those of you who get them. Before I was diagnosed with migraines, I used to pass off the pain as just a headache, before they got worse, but my mother had told my doctor about the visual disturbances because she said it was funny that I would chase 'spots' around the house (or better still, I would try to name my spots before they 'popped' or disappeared!). The doctor actually referred me to a mental health professional. Has anyone else experienced this sort of medical mistake with the auras before being properly diagnosed?"

(b, LiveJournal for Support Group For Migraine Sufferers, March 11, 2005)

In 1975, Ronald Keith Siegel, PhD, and Murray E. Jarvik, MD, PhD, introduced a taxonomy for the evaluation of drug-induced visual hallucinations, distinguishing form, colour and movement dimensions as well as action patterns. The nine categories of form dimension, and examples that illustrate them, are described by these authors as follows:

Categories of form dimension of visual hallucinations (Siegel and Jarvik, 1975)

Random. Blobs, amorphous shapes, blurry patterns, watery patterns with no definite design, etc. (Any form that cannot be classified in the categories below.)
Line. Herringbone patterns, zig-zags, polygons, all angular figures without curves or rounded corners, crosses, etc.
Curve. Circles, ellipses, parabolas, hyperbolas, sine wave patterns, fingerprint whorls, spheres, balls, scribbling, etc.
Web. Spider webs, nets, unsymmetrical lattices and filigrees, veins, etc.
Lattice. Lattices, gratings, grids, screens, fretwork, checkerboard, honeycombs, etc.
Tunnel. Tunnels, funnels, alleys, cones, vessels, pits, corridors, etc.
Spiral. Spirals, pinwheels, springs, etc.
Kaleidoscope. Kaleidoscopes, mandalas, symmetrical snowflakes, lacework, mosaics, symmetrical flowerlike patterns, etc.
Complex. Any recognizable imagery such as faces, people, landscapes, panoramic vistas, animals, inanimate objects, cartoons, etc.

Heinrich Klüver (1897-1979) - (see here)

Heinrich Klüver's hallucinatory form constants (see here)

As implied by Heinrich Klüver's notion of hallucinatory form constants, all these different forms of visual hallucinations can be produced not only by drug intoxication, but also by many other pathological conditions including migraine aura. In the revised edition of his book Migraine, Oliver Sacks (1992) describes these hallucinatory form constants and what they reveal about the working of the brain. Although the zigzags of the fortification spectra are the most frequently encountered and almost pathognomonical type of visual hallucinations encountered as visual migraine aura, visual hallucinations of random, line, curve, web, lattice, tunnel, spiral, kaleidoscope and complex form dimension have all been described as varieties of migraine aura (Podoll and Robinson, 2002). Examples of visual migraine aura hallucinations for each of the nine categories from Siegel and Jarvik's taxonomy will be presented on the following webpages (see the links at the left hand margin of this website).

Visual hallucinations of lattice form dimension as seen in migraine aura

Visual hallucinations of lattice form dimension as seen in LSD intoxication

Migraine aura and psychedelic experience

"I had several episodes of the light shows, when I got to catch up on all of the hallucinogenic sights I didn't go after in the sixties. Both my optometrist and my doctor called them ophthalmic migraines. They both said that if one has to have migraines, these are the best kind to have. They were picturesque, but I'd rather not have them!"

(Suzanne, Newsgroups: alt.med.cfs, Subject: MED: Light Show, July 9, 1996)

"Welcome to the wonderful world of Classic Migraine With Extra Added Aura! In short, yes, sounds like what you've got. I get 'em too, really pretty ones, both in black-and-white flashy styles, which i call 'the op-art aura,' with the 'Big *C*' just as you describe it -- and in colourfully patterned 'psychedelic aura' form that looks like what i used to see when i took LSD in the 1960s. I enjoy them while i can, because the headache that comes after can really be a killer."

(Catherine Yronwode, Newsgroups: alt.support.headaches.migraine, Subject: Aura?????, May 18, 2000)

"Once upon a time, the medical folk put Kbee on Depakote [divalproex sodium] for migraines [see here], whereupon Kbee experienced what she now knows are 'scintillating scotoma', aka the Timothy Leary Memorial Auras. Psychedelic man, complete with animation…"

(kbee, Newsgroups: alt.tv.twin-peaks, Subject: More on Lost Highway [Neurology is Strange], July 26, 2000; additions in square brackets by Klaus Podoll)

"Those who suffer from so-called 'classic' migraine (a.k.a. 'migraine with aura') can tell you a lot about geometric-pattern hallucinations or visual disturbances. Those who have taken LSD-25 AND who suffer from migraine-with-aura can tell you even more. The usenet newsgroup alt.support.headaches.migraine has hosted enough discussion on this subject to fill a book. I wish some scientists would listen to us - we are here in large numbers and the things we see are remarkable, to say the least."

(Catherine Yronwode, Yahoo Groups Sacredlandscapelist, Subject: phosphenes, geometric hallucinations, etc., October 21, 2000)

"The properties of the mind that psychedelics reveal is something universal, and that's been here since the dawn of mankind. The only way it was new was that it brought a welcome change to the culture that was dominating the western world in the 1950s. I prefer Ott and Wassons term 'Entheogen', despite its theological baggage. To bring out the divine within, that is what they do, and if it's a migraine of Lewis Carrollian magnitude, hitting your head on a rock, some foundation-shaking experience or just the 'accidental' ingestion of fenetylamines or tryptamines that cause the experience, is secondary."

(Petter, Newsgroups: alt.music.psychedelic, alt.drugs.psychedelic, Subject: Humphrey Osmand, the man who coined the term Psychedelic, March 28, 2001)

"As it happens, I suffer from classical migraines. Or one at least. Hopefully the next one is a long way off.

But when I started hallucinating and seeing LSD fairies and sunspots in my blinds-down living room on Tuesday morning, I wasn't thinking 'migraine.' When I lost all depth perspective and peripheral vision, I wasn't wondering where we keep the Motrin.

No, after forty minutes when the vision problems -- along with dizziness, nausea, and a fifteen-minute numbness down my right forearm -- hadn't yet gone away, there I was trying to keep working on my laptop, even though my limited eyesight could only actually focus on one letter on the LCD at a time.

It just seemed more important at the time that I successfully type the word 'BRAIN ANEURYSM' into Wikipedia's search engine. Sure I gad a headache. Sure it was a bad one. But I was a little more worried about those LSD fairies in the corner of my eyes that I couldn't quite see because, again, I had no peripheral vision.

After an hour or so, the vision stuff finally cleared up, and I was left feeling nauseated and achy with a 'I have such a migraine' sensation in my head for the next 24 hours.

And it turned out I was right! I did have a migraine! Classical migraine with aura!"

(Alex Wilson's Journal, My first migraine with aura, October 20, 2005)

"Turing [1952] instabilities have been used as models to describe both migraine- and LSD-induced hallucinations [Ermentrout and Cowan, 1979]."

(Timothy K. Callahan, Pattern Formation, undated; additions in square brackets by Klaus Podoll)

"I found your website (www.migraine-aura.org) and was amazed and happy to see the drawings of the aura, so well done. My physician told me it was related to migraines, was in my epileptic centre, but it was innocent and I didn't need to worry. Still it's nice to know I am not the only one and it's quite 'normal'.

My auras started about twenty years ago while working on a computer at a client's site (programmer, partner of a small business here in Canada, at the time Toronto). My vision got slowly blocked with those fantastic light effects and I locked myself up in the washroom (toilet) to see if it would get worse and if I would have to call a doctor, of if it would go away. It was very clear to me, it was NOT in my eyes but had to be in my brain as it showed up in both eyes, closing or opening and that scared me in some ways even more. The client never noticed anything of it, it was important to keep them happy and not lose them, or show any 'weakness', so I was not about to call the ambulance. Now I would have a total different attitude in case something strangeand unknown would happen to me.

Since then I have had it about once a year or two years and it takes exactly 22 minutes to go from one side, mostly left to right, but sometimes the other way, and then disappear. I have the spiral zig zag multi coloured (blue, yellow, black, red lines in the zig zag) wheel that expands, and has a tail to it and it migrates radially as well as moving from one side to the other of the field. I call it my 'psychedelic science fiction special effects' and I find it rather beautiful.

The strange thing is that I have NO headaches. But... my mother had terrible migraine attacks for about 35 years ever since her early thirties with throwing up gall etc. Dark room, stiff band around head, cooling off with cold water etc. So it's probably inherited, but I never heard her talk about those light effects. I wonder now.. she passed away in 2000 at age 78. I am an only child, so can't ask siblings for experiences.

I am from Holland but live since 1983 in Canada and am 54 years old.

When it happens now I will just sit down and wait it out. If I would be driving, I would have enough time to safely put the car on the side of the road."

(Ellen P, Email to Klaus Podoll, October 15, 2007)

"I just came acroos your [i.e. Masonic Boom's] story and this is what I have. Happened for the first time last night. I though I was having an acid flashback. Never heard of it and the drawing was right on except mine was more primary reds, greens, and blues. Wow, thanks for the info."

(A, E-Mail to Klaus Podoll, September 18, 2009)

Are you acquainted with similar phenomena associated with your migraine attacks? Please contact Dr Klaus Podoll if you wish to share and discuss your experiences.

References

Ermentrout GB, Cowan JD. A mathematical theory of visual hallucination patterns. Biol Cyber 1979; 34: 137-150.
Gowers WR. Subjective visual sensations. Trans Ophthalmol Soc UK 1895; 15: 1-38.
Jarvik M. Conversation with Murray Jarvik. Addiction 2001; 96: 1241-1252.
Klüver H. Mechanisms of hallucinations. In: McNemar Q, Merrill MA (eds) Studies in personality. Contributed in honor of Lewis M. Terman. McGraw-Hill, New York-London 1942, 175-207.
Podoll K, Robinson D. Migraine Art - The migraine experience from within. Neurol Psychiat Brain Res 2002; 10: 29-34.
Podoll K, Robinson D. Migraine Art - The Migraine Experience from Within. North Atlantic Books, Berkeley, California 2009, p. 175-250.
Ruck CAP, Bigwood J, Staples D, Ott J, Wasson RG. Entheogens. J Psychedelic Drugs 1979; 11: 145-146.
Sacks OW. Migraine. Revised and expanded. University of California Press, Berkeley-Los Angeles-Oxford 1992.
Siegel RK. Hallucinations. Scientific American 1977; 237: 132-140.
Siegel RK. Intoxication: Life in pursuit of artificial paradise. Dutton, New York, NY 1989.
Siegel RK. Fire in the brain: Clinical tales of hallucination. Dutton, New York, NY 1992.
Siegel RK. Whispers: The voices of paranoia. Crown Publishers, New York 1994.
Siegel RK, Jarvik M. Drug-induced hallucinations in animals and man. In: Siegel R, West L (eds) Hallucinations: Behavior, experience, and theory. John Wiley and Sons, New York, NY 1975, 81-161.
Turing AM. The chemical basis of morphogenesis. Phil Trans Roy Soc B 1952; 237: 37-72.

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