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Migraine Aura Migraine Aura
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Migraine Aura

Tom Johnson, Migraine aura, 2006. © 2006 Tom Johnson

The subsection Symptoms, edited by Klaus Podoll MD, provides a detailed documentation and simulations of transitory and persistent migraine aura symptoms as well as a discussion of the psychological experience of migraine aura.

Animated migraine scotoma. © 2005 Markus Dahlem

The subsection Pathomechanisms, edited by Markus Dahlem PhD, reviews major different theories about the origin of the aura (neural versus vascular theory) and presents modern neurocomputational models that help to understand this complex phenomenon.

Christian Georg Theodor Ruete, Illustration of scintillating scotoma from "Textbook of Ophthalmology", 1845.

The subsection History, jointly edited by Markus Dahlem PhD and Klaus Podoll MD, provides a selection of historical descriptions of migraine with aura from the Anglosaxon, French and German literature, ranging from ancient Mesopotamian texts 3.000 B.C. to 20th century writers such as Sigmund Freud, Bernhard Hassenstein or Marvin Minski.

Experiencing migraine aura – Looking at one's own brain at work

"Some would suggest that the migraine aura is actually the brain apprehending its own subroutines in consciousness. The fact that there are natural equivalents to drug-induced experiences suggests the possibility that in some sense, a sufferer is observing what's going on in the brain. The drugged or migrained brain is a cranked-up biochemical computer capable of picturing the self-organizing behavior and nonlinear dynamism at play within normally staid reality."

(borourke, everything, February 8, 2000)

MediaValet, Scintillating scotoma, 2007. "This is an animated depiction of a visual phenomena that occurs either before a migraine headache, or by itself. These typically last up to 30 minutes. This video speeds up the timeframe of this phenomena to 30 seconds." © 2007 MediaValet (see here)

MediaValet, Scintillating Scotoma, 2008. "A message from MedaValet, the animator of Scintillating Scotoma." © 2008 MediaValet (see here)

beekman33, What a migraine headache looks like, 2007. "What a migraine headache looks like with the aura, when you have swelling behind your eye, it looks like this. Yeah, not so fun. Any headachers see this?" © 2007 beekman33 (see here)

kaffir3, Optical Migraine, 2007. "This is kinda sorta what one looks like. It's over when it expands out of the field of vision." © 2007 kaffir3 (see here)

rkraig, Video 1. Visual aura of migraine, 2008. "Video-1 shows a visual aura from migraine headache like that suffered by Lashley and reported in 1941. 'Normal vision' is transferred to the occipital brain cortex. The visual migraine aura begins with a 'visual obscuration,' or positive (pink stippling) alteration in vision that is followed by a loss (gray) of vision. This change took 22 minutes to cross his visual field, a distance of 67 mm in occipital cortex. Accordingly, Lashley concluded his migraine aura traveled at 3 millimeters/minute, an unheard of slow rate. (This video was created with the assistance of Mr. Dale Mertes from the University of Chicago.)" © 2008 rkraig (see here)

rkraig, Video 2. Spreading depression and migraine, 2008. "Spreading depression is the likely cause for migraine aura and pain. It is found in normal brain and shown here triggered in a brain slice (gray) by an electrical pulse (red posts to the lower right) and recorded by the electrode to the left to illustrate the basic components and how they relate to migraine aura. Normal electrical activity of brain is seen as small vertical deflections in white line (1). Then with the onset of spreading depression, this activity often increases (2), which likely presents the visual obscuration (flashing lights, etc) of the aura (see video 1). Next when the increased activity is sufficiently coordinated, spreading depression is triggered (3), which briefly stops all brain activity in that area (4) before returning to normal (visual loss (scotoma) of the aura). Importantly, spreading depression (migraine) is triggered by a loss of brain cell inhibition and consists of a complete loss of brain activity (that is seen here as a large DC negative potential) that propagates (at 3 millimeters/minute) across brain. This is the only event of brain that moves this slowly. The movement is shown in video 3. (This video was created with the assistance of Mr. Dale Mertes from the University of Chicago.)" © 2008 rkraig (see here)

rkraig, Video 3. Spreading depression propagation in a brain slice, 2008. "Video 3. Spreading depression propagation in a brain slice. Spreading depression, the likely cause of migraine aura and pain, begins from an initial flurry of increase brain activity that becomes sufficiently coordinated over an expanse of brain. Spreading depression itself consists of a brief, complete loss of brain activity that propagates across involved brain at three millimeters a minute. This video shows this propagation at this very slow rate sped up here for illustrative purposes. Images are from a voltage dye that records brain cell potential (pink). With spreading depression brain cell potentials are lost (block) as the spreading depression moves across involved tissue. (This video was created with the assistance of Ms. Jane Babiarz from the University of Chicago.)" © 2008 rkraig (see here)

loading 73, Migraine aura, 2008. "This is what I see when I get a migraine. I should mention that this depicts a best case scenario in which I take an Almotriptan pill and I am functional again in an hour." © 2008 loading 73 (see here)

Peter Glynn, Migraine Aura: A Personal Case Study, 2009. "Two days ago I discovered a condition I had been experiencing for the past 10 years had a name : Migraine Aura. I was no longer worried that I had some degenerative eye disease or brain tumor. Nor was I alone in having to cope with this condition." © 2008 Peter Glynn (see here)

frusseldiz, Migraine Aura Simulation, 2009. "After years of trying to explain what the visual effects of Migraine aura look like, I finally tried to create a little movie simulation to help. This simulation isn't totally accurate, but it does convey something of the character of migraine aura, or at least the kind I experience. Perhaps this could be useful for others. I recommend watching it with the high quality ("HQ") setting turned on." © 2009 fusseldiz (see here)

References

Dahlem MA, Chronicle EP. Computational perspective on migraine aura. Prog Neurobiol 2004; 74: 351-361.
de Jong PT. [What do you actually see? Visual impairments and their simulation for well-seeing subjects] [Article in Dutch] Ned Tijdschr Geneeskd 2003; 147: 2540-2550.
Grossinger R. Migraine Auras: When the Visual World Fails. North Atlantic Books, Berkeley California 2006.
Podoll K, Robinson D. Migraine Art - The Migraine Experience from Within. North Atlantic Books, Berkeley, California 2009.
Sacks OW. Migraine. Revised and expanded. University of California Press, Berkeley-Los Angeles-Oxford 1992.

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NEW BOOK: Klaus Podoll & Derek Robinson, Migraine Art - The Migraine Experience from Within