Migraine, by Oliver Sacks. Medical terminology, professional reading
Description
Vocal Characteristics
Language
EnglishVoice Age
Middle Aged (35-54)Accents
North American (General)Transcript
Note: Transcripts are generated using speech recognition software and may contain errors.
migraine by Oliver sacks. Chapter one Common Migraine begins with a quote from Dubois Raymond 1860, Since about my 20th year, though otherwise in good health. I have suffered from Migraine every three or four weeks. I'm liable to an attack. I wake with a general feeling of disorder and a slight pain in the region of the right temple, which, without overstepping the midline, reaches its greatest intensity at midday towards evening it usually passes off while at rest. The pain is bearable, but it is increased by motion to a high degree of violence. It responds to each beat of the temporal artery. The latter feels on the affected side like a hard cord. While the left is in its normal condition. The countenance is pale and sunken, the right eyes, small and reddened at the height of the attack. When it is a violent one, there is nausea, there may be left behind a slight gastric disorder frequently. Also the scalp remains tender at one spot the following morning for a certain period after the attack. I can expose myself with impunity to influences which before would have infallibly caused an attack, and, quote, the cardinal symptoms of common migraine are headache and nausea, complementing these maybe a remarkable variety of other major symptoms. In addition to minor disorders and physiological changes of which the patient may not be aware, presiding over the entire attack. There will be, in Dubois Raymond's words, a general feeling of disorder, which may be experienced in either physical or emotional terms and tax, or elude the patient's powers of description. Great variability of symptoms is characteristic not only of attacks in different patients, but between successive attacks and the same patient. These then are the ingredients of a common migraine. We will list and describe them one by one while understanding that migrant symptoms never occur in such schematic isolation but are linked to one another in various ways. Some symptoms are conjoined to form characteristic constellations while others present themselves in a definite and often dramatic order, so that we may recognize a basic sequence to the attacks. Headache. Quote from Peter's 1853 begin, quote, the character of the pains varied very much most frequently. They were of a hammering, throbbing or pushing nature in other cases pressing and dull, boring with sense of bursting, pricking, rending, stretching, piercing and radiating. In a few cases it felt as if a wedge was pressed into the head or like an ulcer or as if the brain was torn or pressed outwards. End, quote, migraine headache is traditionally described as a violent throbbing pain in one temple, and not infrequently takes this form. It is impossible, however, to specify a constant site quality or intensity for in the course of a specialized practice, one will encounter all conceivable varieties of head pain in the context of migraine Wolf, whose experience is unmatched in this area has stated 1963 quote, the sites of the migraine headaches are notably temporal, super orbital frontal retro bulb, our parietal, post auricular and occipital. They may occur as well in the mala region in the upper and the lower teeth at the base of the nose, in the median wall of the orbit, in the neck, and in the region of the common carotid arteries and down as far as the tip of the shoulder end, quote. one may say, however, that migraine headache is unilateral in onset more frequently than not, although it tends to become diffuse and distribution later in the attack. One side is generally attacked by preference, and in a few patients there may be an invariable left or right sided involvement throughout life. More commonly, there is only a relative preference, often associated with the severity of pain. Severe frequent hemicrania on one side, with mild, occasional hemicrania on the opposite side. A number of patients complain of an alternation of hemicrania from one side to the other in successive attacks or even in the same attack. At least a third of all patients experience a bilateral or diffuse headache. Holyoke Rania from the onset of the attack. The quality of migraine headache is similarly variable, throbbing, occurs in less than half of all cases, and in these may characterize the headache only at its inception, soon giving way to a steady aching, continued throbbing throughout the attack is uncommon and occurs chiefly in those who drive themselves to continued physical activity despite a migraine throbbing when it occurs is synchronized with arterial pulsation and may be accompanied by visible pulsation of extra cranial arteries.