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Migraine
From the renowned neurologist and bestselling author of Awakenings and The Man Who Mistook His Wife for a Hat comes a fascinating investigation of the many manifestations of migraine, including the visual hallucinations and distortions of space, time, and body image which migraineurs can experience.
“So erudite, so gracefully written, that even those people fortunate enough never to have had a migraine in their lives should find it equally compelling.” —The New York Times
The many manifestations of migraine can vary dramatically from one patient to another, even within the same patient at different times. Among the most compelling and perplexing of these symptoms are the strange visual hallucinations and distortions of space, time, and body image which migraineurs sometimes experience. Portrayals of these uncanny states have found their way into many works of art, from the heavenly visions of Hildegard von Bingen to Alice in Wonderland. Dr. Oliver Sacks argues that migraine cannot be understood simply as an illness, but must be viewed as a complex condition with a unique role to play in each individual's life.
“So erudite, so gracefully written, that even those people fortunate enough never to have had a migraine in their lives should find it equally compelling.” —The New York Times
The many manifestations of migraine can vary dramatically from one patient to another, even within the same patient at different times. Among the most compelling and perplexing of these symptoms are the strange visual hallucinations and distortions of space, time, and body image which migraineurs sometimes experience. Portrayals of these uncanny states have found their way into many works of art, from the heavenly visions of Hildegard von Bingen to Alice in Wonderland. Dr. Oliver Sacks argues that migraine cannot be understood simply as an illness, but must be viewed as a complex condition with a unique role to play in each individual's life.
338 pages, Paperback
First published January 1, 1970
712 people are currently reading
8071 people want to read
About the author
Oliver Sacks
102 books9,732 followersOliver Wolf Sacks, CBE, was a British neurologist residing in the United States, who has written popular books about his patients, the most famous of which is Awakenings, which was adapted into a film of the same name starring Robin Williams and Robert De Niro.
Sacks was the youngest of four children born to a prosperous North London Jewish couple: Sam, a physician, and Elsie, a surgeon. When he was six years old, he and his brother were evacuated from London to escape The Blitz, retreating to a boarding school in the Midlands, where he remained until 1943. During his youth, he was a keen amateur chemist, as recalled in his memoir Uncle Tungsten. He also learned to share his parents' enthusiasm for medicine and entered The Queen's College, Oxford University in 1951, from which he received a Bachelor of Arts (BA) in physiology and biology in 1954. At the same institution, he went on to earn in 1958, a Master of Arts (MA) and an MB ChB in chemistry, thereby qualifying to practice medicine.
After converting his British qualifications to American recognition (i.e., an MD as opposed to MB ChB), Sacks moved to New York, where he has lived since 1965, and taken twice weekly therapy sessions since 1966.
Sacks began consulting at chronic care facility Beth Abraham Hospital (now Beth Abraham Health Service) in 1966. At Beth Abraham, Sacks worked with a group of survivors of the 1920s sleeping sickness, encephalitis lethargica, who had been unable to move on their own for decades. These patients and his treatment of them were the basis of Sacks' book Awakenings.
His work at Beth Abraham helped provide the foundation on which the Institute for Music and Neurologic Function (IMNF), where Sacks is currently an honorary medical advisor, is built. In 2000, IMNF honored Sacks, its founder, with its first Music Has Power Award. The IMNF again bestowed a Music Has Power Award on Sacks in 2006 to commemorate "his 40 years at Beth Abraham and honor his outstanding contributions in support of music therapy and the effect of music on the human brain and mind".
Sacks was formerly employed as a clinical professor of neurology at the Albert Einstein College of Medicine and at the New York University School of Medicine, serving the latter school for 42 years. On 1 July 2007, Columbia University College of Physicians and Surgeons appointed Sacks to a position as professor of clinical neurology and clinical psychiatry, at the same time opening to him a new position as "artist", which the university hoped will help interconnect disciplines such as medicine, law, and economics. Sacks was a consultant neurologist to the Little Sisters of the Poor, and maintained a practice in New York City.
Since 1996, Sacks was a member of The American Academy of Arts and Letters (Literature). In 1999, Sacks became a Fellow of the New York Academy of Sciences. Also in 1999, he became an Honorary Fellow at The Queen's College, Oxford. In 2002, he became Fellow of the American Academy of Arts and Sciences (Class IV—Humanities and Arts, Section 4—Literature).[38] and he was awarded the 2001 Lewis Thomas Prize by Rockefeller University. Sacks was awarded honorary doctorates from the College of Staten Island (1991), Tufts University (1991), New York Medical College (1991), Georgetown University (1992), Medical College of Pennsylvania (1992), Bard College (1992), Queen's University (Ontario) (2001), Gallaudet University (2005), University of Oxford (2005), Pontificia Universidad Católica del Perú (2006). He was appointed Commander of the Order of the British Empire (CBE) in the 2008 Birthday Honours. Asteroid 84928 Oliversacks, discovered in 2003 and 2 miles (3.2 km) in diameter, has been named in his honor.
Sacks was the youngest of four children born to a prosperous North London Jewish couple: Sam, a physician, and Elsie, a surgeon. When he was six years old, he and his brother were evacuated from London to escape The Blitz, retreating to a boarding school in the Midlands, where he remained until 1943. During his youth, he was a keen amateur chemist, as recalled in his memoir Uncle Tungsten. He also learned to share his parents' enthusiasm for medicine and entered The Queen's College, Oxford University in 1951, from which he received a Bachelor of Arts (BA) in physiology and biology in 1954. At the same institution, he went on to earn in 1958, a Master of Arts (MA) and an MB ChB in chemistry, thereby qualifying to practice medicine.
After converting his British qualifications to American recognition (i.e., an MD as opposed to MB ChB), Sacks moved to New York, where he has lived since 1965, and taken twice weekly therapy sessions since 1966.
Sacks began consulting at chronic care facility Beth Abraham Hospital (now Beth Abraham Health Service) in 1966. At Beth Abraham, Sacks worked with a group of survivors of the 1920s sleeping sickness, encephalitis lethargica, who had been unable to move on their own for decades. These patients and his treatment of them were the basis of Sacks' book Awakenings.
His work at Beth Abraham helped provide the foundation on which the Institute for Music and Neurologic Function (IMNF), where Sacks is currently an honorary medical advisor, is built. In 2000, IMNF honored Sacks, its founder, with its first Music Has Power Award. The IMNF again bestowed a Music Has Power Award on Sacks in 2006 to commemorate "his 40 years at Beth Abraham and honor his outstanding contributions in support of music therapy and the effect of music on the human brain and mind".
Sacks was formerly employed as a clinical professor of neurology at the Albert Einstein College of Medicine and at the New York University School of Medicine, serving the latter school for 42 years. On 1 July 2007, Columbia University College of Physicians and Surgeons appointed Sacks to a position as professor of clinical neurology and clinical psychiatry, at the same time opening to him a new position as "artist", which the university hoped will help interconnect disciplines such as medicine, law, and economics. Sacks was a consultant neurologist to the Little Sisters of the Poor, and maintained a practice in New York City.
Since 1996, Sacks was a member of The American Academy of Arts and Letters (Literature). In 1999, Sacks became a Fellow of the New York Academy of Sciences. Also in 1999, he became an Honorary Fellow at The Queen's College, Oxford. In 2002, he became Fellow of the American Academy of Arts and Sciences (Class IV—Humanities and Arts, Section 4—Literature).[38] and he was awarded the 2001 Lewis Thomas Prize by Rockefeller University. Sacks was awarded honorary doctorates from the College of Staten Island (1991), Tufts University (1991), New York Medical College (1991), Georgetown University (1992), Medical College of Pennsylvania (1992), Bard College (1992), Queen's University (Ontario) (2001), Gallaudet University (2005), University of Oxford (2005), Pontificia Universidad Católica del Perú (2006). He was appointed Commander of the Order of the British Empire (CBE) in the 2008 Birthday Honours. Asteroid 84928 Oliversacks, discovered in 2003 and 2 miles (3.2 km) in diameter, has been named in his honor.
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Displaying 1 - 30 of 258 reviews
February 21, 2008
This book was originally written in 1970 with subsequent revisions in '85 and '92. Given that it's slightly outdated I wasn't sure how relevant it would be, especially considering all the different migraine medications they have now. I couldn't have been more wrong!
The wonderful thing about Dr. Sacks is that he's not all about standardized, generalized drug-treatment and he has a full respect for nature. He considers each case and patient as an individual human being with all the uniqueness that implies.
In addition, I was fascinated to read historical perspectives on migraine and realize that some of the insights from hundreds, if not thousands, of years ago are relevant and spot-on today.
As someone who grew up with a neurologist father and watched my mother suffer terrible migraines only to develop them myself at age 12, I obviously had a selfish, personal interest in this book. When in my mid-30s I developed a migraine that wouldn't go away (Sacks writes "migraine gathers identity from stage to stage, for it starts as a reflex, but can become a creation") and spent the next two years going to the top migraine neurologists (one of whom Dr. Sacks quotes) and taking countless drugs.
Eventually, realizing that the drugs were making me feel worse than the migraine, I stopped it all and have been developing ways to manage it on my own.
In reading Dr. Sacks' book, I now realize that it was not the drugs alone that were exacerbating my situation...it was the doctors! "The physician must not dominate or be dogmatic to the patient, must not play the expert, insist "I know best"; he must listen to the patient; listen beneath words; listen to what his illness, the migraine, is "saying".
My biggest frustration was that these "experts" that I sought help from did dominate and did insist that they knew best, to the point of literally telling me that some of the symptoms I described were not possible! If I could have Dr. Sacks as my doc, I might actually consider seeking medical advice again.
Of further interest, Sacks provides numerous case histories and artistic renderings of what migraine aura look like as experienced by the migraineur. What a validation this was! I now have an actual picture I can point to and say "that's what it's like" when people ask me to describe my auras.
Lastly, he provides a brief appendix discussing the "visions of Hildegard" and how there's "no room for doubt concerning their nature: they were indisputably migrainous". The excerpts from Hildegard's writings provided, once again, great validation and a beautiful new way in which to envision my migraine auras/visions.
In the end, an excellent book for somone with migraines, but more importantly, for those who treat people with migraines to read. Sacks is a physician, so at times the book can be a bit heavy on the medical jargon, but not so much as to overwhelm. In addition to being a thoughtful, empathetic, and extremely knowlegeable physician, Dr. Sacks is also an excellent writer who uses language beautifully.
The wonderful thing about Dr. Sacks is that he's not all about standardized, generalized drug-treatment and he has a full respect for nature. He considers each case and patient as an individual human being with all the uniqueness that implies.
In addition, I was fascinated to read historical perspectives on migraine and realize that some of the insights from hundreds, if not thousands, of years ago are relevant and spot-on today.
As someone who grew up with a neurologist father and watched my mother suffer terrible migraines only to develop them myself at age 12, I obviously had a selfish, personal interest in this book. When in my mid-30s I developed a migraine that wouldn't go away (Sacks writes "migraine gathers identity from stage to stage, for it starts as a reflex, but can become a creation") and spent the next two years going to the top migraine neurologists (one of whom Dr. Sacks quotes) and taking countless drugs.
Eventually, realizing that the drugs were making me feel worse than the migraine, I stopped it all and have been developing ways to manage it on my own.
In reading Dr. Sacks' book, I now realize that it was not the drugs alone that were exacerbating my situation...it was the doctors! "The physician must not dominate or be dogmatic to the patient, must not play the expert, insist "I know best"; he must listen to the patient; listen beneath words; listen to what his illness, the migraine, is "saying".
My biggest frustration was that these "experts" that I sought help from did dominate and did insist that they knew best, to the point of literally telling me that some of the symptoms I described were not possible! If I could have Dr. Sacks as my doc, I might actually consider seeking medical advice again.
Of further interest, Sacks provides numerous case histories and artistic renderings of what migraine aura look like as experienced by the migraineur. What a validation this was! I now have an actual picture I can point to and say "that's what it's like" when people ask me to describe my auras.
Lastly, he provides a brief appendix discussing the "visions of Hildegard" and how there's "no room for doubt concerning their nature: they were indisputably migrainous". The excerpts from Hildegard's writings provided, once again, great validation and a beautiful new way in which to envision my migraine auras/visions.
In the end, an excellent book for somone with migraines, but more importantly, for those who treat people with migraines to read. Sacks is a physician, so at times the book can be a bit heavy on the medical jargon, but not so much as to overwhelm. In addition to being a thoughtful, empathetic, and extremely knowlegeable physician, Dr. Sacks is also an excellent writer who uses language beautifully.
December 31, 2010
As a chronic migraine sufferer, I found Sack's work to be a huge disappointment. His information was outdated and biased towards the traditional attitude that migraines are stress induced. Migraines are so much more complicated than originally thought, a complex chemical and electrical reaction that can be set in motion by extremely diverse causes from brain tumors to multiple sclerosis to spinal injury, not to mention hormonal changes, trigger exposure, and altitude sickness, just to name a few. I would have expected a more enlightened, better researched book from such a luminary. Don't bother.
March 22, 2024
Migraines have plagued me since the age of around nine years old, coincidentally, the age I started menstruating, and I'm slightly embarrassed to say that apart from googling information about them, this particular book is the first I've read about the condition.
I'm not going to lie, this was some heavy stuff, of which some of it went over my head, but it was incredibly fascinating despite that. Dr Sacks has filled this book with detailed explanations about every migraine that is known, with helpful snippets of case studies of past patients. I found these case studies especially interesting, as a few of these sounded similar to my migraine patterns and symptoms.
Moving on to symptoms...I had no idea that there are so many, apart from the actual throbbing headache itself. With mine, I didn't usually get much warning apart from the headache creeping up on me over my left eye (always the left) and the gradually getting more painful until I was knocked off my feet with sickness, sleeping it off for hours. I actually remember being hospitalised for a couple of mine as a child, too. They can be pretty terrifying.
While this book doesn't really offer all the answers, it does provide the reader with a knowledgeable insight of migraine from a person that suffered with them, and I found that enough to hold my attention to the end.
I'm not going to lie, this was some heavy stuff, of which some of it went over my head, but it was incredibly fascinating despite that. Dr Sacks has filled this book with detailed explanations about every migraine that is known, with helpful snippets of case studies of past patients. I found these case studies especially interesting, as a few of these sounded similar to my migraine patterns and symptoms.
Moving on to symptoms...I had no idea that there are so many, apart from the actual throbbing headache itself. With mine, I didn't usually get much warning apart from the headache creeping up on me over my left eye (always the left) and the gradually getting more painful until I was knocked off my feet with sickness, sleeping it off for hours. I actually remember being hospitalised for a couple of mine as a child, too. They can be pretty terrifying.
While this book doesn't really offer all the answers, it does provide the reader with a knowledgeable insight of migraine from a person that suffered with them, and I found that enough to hold my attention to the end.
June 28, 2020
Embora o trabalho de Oliver Sacks seja sempre relevante e interessante de ler - seja o leitor um leigo em neurociências ou não - neste livro em particular a informação encontra-se datada e um pouco tendenciosa, sendo que a investigação sobre a enxaqueca evoluiu bastante nas últimas décadas além do descrito aqui.
A primeira metade do livro é a mais interessante e relevante, com a categorização da enxaqueca nas suas diferentes classificações, explicação da mesma e inúmeros casos clínicos muito interessantes.
Recomendo a quem esteja interessado no tema, com atenção ao enquadramento temporal e científico da obra (publicada inicialmente nos anos 70 e com revisões dos anos 90) e com a nota de que não se trata da literatura mais moderna e exata sobre o tema em questão
A primeira metade do livro é a mais interessante e relevante, com a categorização da enxaqueca nas suas diferentes classificações, explicação da mesma e inúmeros casos clínicos muito interessantes.
Recomendo a quem esteja interessado no tema, com atenção ao enquadramento temporal e científico da obra (publicada inicialmente nos anos 70 e com revisões dos anos 90) e com a nota de que não se trata da literatura mais moderna e exata sobre o tema em questão
June 10, 2011
Recently I had what was diagnosed as an ophthalmic migraine, or a scintillating scotoma. This was the second event in about 2 months. There was no pain associated with it, and apparently it is not a dangerous condition, but it was certainly attention-getting. I had been interested in this book for several years, so I took the occasion to read it. While I am an Oliver Sacks fan, this is my least favorite of his books so far (I've read almost all of them). His strength is when he looks at some case study and follows it deep and wide. He is unequalled at that. Here he undertakes something else--to give an account of a wide-ranging phenomenon. Ideally this would amount to a theory of migraine--its cause, nature, and treatment. He fortunately is wary and honest enough to know that the phenomena of migraine are extremely wide-ranging, so the prospects of saying something both interesting and applicable to the full range of phenomena are small. But the desire to do so nevertheless opens one to the temptation of saying things that are vague or untestable. Sacks does not avoid these temptations. But for the most part he is true to the phenomena.
The deepest problem comes from the title of the book itself. We have this word "migraine," and so we suppose there must be something in reality that corresponds to it, about which we could have a theory. But when we are told that while "classical" migraines include headache and auras, and
"common" migraines include headache but not auras, and auras by themselves can be "migrainous" phenomena even without pain (which is what I had), I wonder what you can do with that. One could take Wittgenstein's approach that a concept (like "migraine") can have a family-resemblance unity, that depends only on a variety of connections, none of which is necessary or common. Or one could take Socrates' approach that there must be some underlying unity of necessary and sufficient conditions (which seems awfully unlikely in this case). Or one could hold that the term "migraine" has just gotten out of hand, and is in need of some cleaning-up. This is the view sometimes called "eliminativism"--in that the term should be eliminated, and replaced by other more specific terms. This was the fate of earlier terms like "consumption" (the medical term, not the economic term--which was jettisoned in favor of more specific conditions such as pleurisy, lung cancer, emphysema, and tuberculosis). It would seem more profitable to separate out the variety of phenomena that go under the label of migraine, rather than persevering in a search for what holds it all together. This search for what holds it all together leads Sacks to emphasize the psychological over the physical aspects, since it's pretty clear there isn't a physical unity. Sacks may be right that we should not ignore the psychological aspects, but that may be more a consequence of his search for a unity--somewhere, somehow.
The deepest problem comes from the title of the book itself. We have this word "migraine," and so we suppose there must be something in reality that corresponds to it, about which we could have a theory. But when we are told that while "classical" migraines include headache and auras, and
"common" migraines include headache but not auras, and auras by themselves can be "migrainous" phenomena even without pain (which is what I had), I wonder what you can do with that. One could take Wittgenstein's approach that a concept (like "migraine") can have a family-resemblance unity, that depends only on a variety of connections, none of which is necessary or common. Or one could take Socrates' approach that there must be some underlying unity of necessary and sufficient conditions (which seems awfully unlikely in this case). Or one could hold that the term "migraine" has just gotten out of hand, and is in need of some cleaning-up. This is the view sometimes called "eliminativism"--in that the term should be eliminated, and replaced by other more specific terms. This was the fate of earlier terms like "consumption" (the medical term, not the economic term--which was jettisoned in favor of more specific conditions such as pleurisy, lung cancer, emphysema, and tuberculosis). It would seem more profitable to separate out the variety of phenomena that go under the label of migraine, rather than persevering in a search for what holds it all together. This search for what holds it all together leads Sacks to emphasize the psychological over the physical aspects, since it's pretty clear there isn't a physical unity. Sacks may be right that we should not ignore the psychological aspects, but that may be more a consequence of his search for a unity--somewhere, somehow.
March 2, 2014
The book synopsis pretty much says it all.
I read this years ago. I remember it well because I could relate to a lot of what Sacks was saying. Still, it was somewhat frustrating and disappointing not getting a definite medical description or definition for migraine, and realising that there is no cure. And all migraineurs have different triggers and different physical symptoms.
I have since found a real gem a book on the subject, The Keeler Migraine Method: A Groundbreaking, Individualized Treatment Program from the RenownedHeadache Clinic which explains migraine as a physical disability. It is a disfunction of sensory processing.
I read this years ago. I remember it well because I could relate to a lot of what Sacks was saying. Still, it was somewhat frustrating and disappointing not getting a definite medical description or definition for migraine, and realising that there is no cure. And all migraineurs have different triggers and different physical symptoms.
I have since found a real gem a book on the subject, The Keeler Migraine Method: A Groundbreaking, Individualized Treatment Program from the RenownedHeadache Clinic which explains migraine as a physical disability. It is a disfunction of sensory processing.
May 17, 2015
Visual migraines are terrifying experiences that physicians (and eye doctors) do not typically treat. This book was recommended by bloggers reporting on their own experiences, so I bought the book. The author gives an in-depth scientific treatment of migraines in general and visual migraines (auras) in particular. The book is written on a college science level.
Some famous people with auras are mentioned and numerous artistic representations of auras are shown. Biological explanations are given and potential medications are discussed, as well as other strategies for dealing with auras. Some myths are dispelled.
The biological explanations of aura are complex and no known cure exists. Various medications work for different people in different ways, and so are not generally recommended. "Knowing your enemy" helps remove the fear and cope with the situation.
I am glad that I bought the book because it at least provided validation. "Yeah, that's what it's like." "Oh, lots of other people are experiencing the same thing." "These other people have historically coped with this and I can cope with it, too."
Some famous people with auras are mentioned and numerous artistic representations of auras are shown. Biological explanations are given and potential medications are discussed, as well as other strategies for dealing with auras. Some myths are dispelled.
The biological explanations of aura are complex and no known cure exists. Various medications work for different people in different ways, and so are not generally recommended. "Knowing your enemy" helps remove the fear and cope with the situation.
I am glad that I bought the book because it at least provided validation. "Yeah, that's what it's like." "Oh, lots of other people are experiencing the same thing." "These other people have historically coped with this and I can cope with it, too."
August 27, 2011
I've been reading quite a bit of Oliver Sacks lately and now I realise I've been reading the populist works. He can do easy read and he can do medical. This one is medical.
However, I read it all the way through and I found it very interesting, even though there were quite a few medical terms that went right over my head. I think I was able to read the whole book simply because I do have migraines, so it all seemed personal, even the bits I didn't find entertaining and didn't really understand.
What I most like about Sacks is the fact that he clearly finds everything he writes about so intensely interesting. He must have been thinking about migraine for decades.
I don't think reading this book changed my understanding of what migraine is and how it affects people. Although it probably did tell me things I didn't know, it didn't tell me them in a way I could carry away with me. But I'm glad I read it.
However, I read it all the way through and I found it very interesting, even though there were quite a few medical terms that went right over my head. I think I was able to read the whole book simply because I do have migraines, so it all seemed personal, even the bits I didn't find entertaining and didn't really understand.
What I most like about Sacks is the fact that he clearly finds everything he writes about so intensely interesting. He must have been thinking about migraine for decades.
I don't think reading this book changed my understanding of what migraine is and how it affects people. Although it probably did tell me things I didn't know, it didn't tell me them in a way I could carry away with me. But I'm glad I read it.
August 13, 2016
I read this book when I was in college, suffering from multiple classical migraines every week. It taught me to treat my migraines by hitting them hard with aspirin and coffee, just as I started to see the visual disturbance. I still get migraines from time to time, but never get a headache.
Interestingly, Excedrin is an implementation of the Sacks treatment, because it contains aspirin, caffeine, and acetaminophen.
Interestingly, Excedrin is an implementation of the Sacks treatment, because it contains aspirin, caffeine, and acetaminophen.
April 24, 2021
Magnífico
January 25, 2024
This was pretty dated (orig. published in 1970) and not written in the "popular" narrative style Sacks is known for by the reading public. I didn't mind the technical writing and appreciated the medical terminology, but took it with a grain of salt (and skimmed) because so much research has been done since 1970 (and the 1992 update). I was most interested in the long section on migraine auras. The case histories were also valuable because they were timeless.
August 17, 2021
Un libro veramente molto interessante. Mi è servito del tempo per terminarlo ma ne è valsa la pena, poi io soffro di emicrania quindi ho capito molte più cose di quanto immaginassi. E soprattutto ho capito, e Sacks lo ripete più volte, puoi lavorare per curare l'emicrania ma non si possono fare miracoli.
June 22, 2025
This book is not only woefully outdated (1992), it is pure, dry academic jargon. I skimmed more than I read.
As a migraine patient, I can confirm that the disease is highly misunderstood and its patients dismissed either as hypochondriacs or time-wasters for seeking care for a “harmless” disorder. Recent research shows that it is not as harmless as first thought, not to mention the patients who are thinking of suicide to either escape the pain or in a deep depression between attacks.
The book spends a lot of time on aura, saying that nobody pays attention to aura. Everybody talks about aura! Every single medical provider I see asks about aura with eagerness. But only 20 percent of patients actually have aura. I skipped most of these sections.
The book has a section on triggers, which is still very accurate. It puts forth several hypotheses about why some people get migraines and how they start. Much more has been discovered about these topics in the last ten years.
At the time the book was written, ergotamine was the most advanced migraine treatment. It’s now obsolete. Triptans weren’t even around at the time of the book’s writings, not to mention the latest break-throughs with gepants, which are highly promising. The terms “common migraine” and “classic migraine” have been retired since the book was written. We now use “migraine without aura” and “migraine with aura.”
This is not like Dr. Sacks’s other books; it’s very scientific and meant to test the fortitude of medical patients.
I’m going to try to describe a migraine attack for those who are curious:
Imagine having heat stroke, where you throw up every twenty minutes, yet this does nothing to decrease the nausea. On top of that, you have something inside your head that is jackhammering your skull with a sledgehammer that matches your heartbeat. Even the dimmest of lights feels like the sun is inches from your eyes; the slightest noise feels like a death metal concert that only encourages the sledgehammer demon. The slightest touch increases the nausea tenfold. Sometimes you beat your head against the ground to get some relief, more likely you will put on your hair as hard as you can and/or press your fingernails into your head. The pain interferes with your ability to form thoughts. A phrase from a recent TV show or conversation will repeat in your mind over and over, obsessively. You might have some stroke symptoms, such as going numb in half your body or a weird tingling sensation at the extremities. This will go on for an average of 12 hours; could be more. When it’s over, you are utterly exhausted. Walking to another room feels like running a mile. It can take days to recover. But another attack is waiting to occur just three or four days later—maybe even the next day. And this is how you live your life, and people offer helpful suggestions such as, “Did you try ibuprofen?” and “You must be exaggerating; you’re such a baby. I get headaches and don’t feel that bad.” So then you try to hide it from people, powering through work and school, throwing up in your mouth and swallowing it down again (because at that point it’s just saliva) and you have to keep going to afford the healthcare that has a shortage of neurologists and medicine you can’t really afford anyway.
Clean content
As a migraine patient, I can confirm that the disease is highly misunderstood and its patients dismissed either as hypochondriacs or time-wasters for seeking care for a “harmless” disorder. Recent research shows that it is not as harmless as first thought, not to mention the patients who are thinking of suicide to either escape the pain or in a deep depression between attacks.
The book spends a lot of time on aura, saying that nobody pays attention to aura. Everybody talks about aura! Every single medical provider I see asks about aura with eagerness. But only 20 percent of patients actually have aura. I skipped most of these sections.
The book has a section on triggers, which is still very accurate. It puts forth several hypotheses about why some people get migraines and how they start. Much more has been discovered about these topics in the last ten years.
At the time the book was written, ergotamine was the most advanced migraine treatment. It’s now obsolete. Triptans weren’t even around at the time of the book’s writings, not to mention the latest break-throughs with gepants, which are highly promising. The terms “common migraine” and “classic migraine” have been retired since the book was written. We now use “migraine without aura” and “migraine with aura.”
This is not like Dr. Sacks’s other books; it’s very scientific and meant to test the fortitude of medical patients.
I’m going to try to describe a migraine attack for those who are curious:
Imagine having heat stroke, where you throw up every twenty minutes, yet this does nothing to decrease the nausea. On top of that, you have something inside your head that is jackhammering your skull with a sledgehammer that matches your heartbeat. Even the dimmest of lights feels like the sun is inches from your eyes; the slightest noise feels like a death metal concert that only encourages the sledgehammer demon. The slightest touch increases the nausea tenfold. Sometimes you beat your head against the ground to get some relief, more likely you will put on your hair as hard as you can and/or press your fingernails into your head. The pain interferes with your ability to form thoughts. A phrase from a recent TV show or conversation will repeat in your mind over and over, obsessively. You might have some stroke symptoms, such as going numb in half your body or a weird tingling sensation at the extremities. This will go on for an average of 12 hours; could be more. When it’s over, you are utterly exhausted. Walking to another room feels like running a mile. It can take days to recover. But another attack is waiting to occur just three or four days later—maybe even the next day. And this is how you live your life, and people offer helpful suggestions such as, “Did you try ibuprofen?” and “You must be exaggerating; you’re such a baby. I get headaches and don’t feel that bad.” So then you try to hide it from people, powering through work and school, throwing up in your mouth and swallowing it down again (because at that point it’s just saliva) and you have to keep going to afford the healthcare that has a shortage of neurologists and medicine you can’t really afford anyway.
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July 10, 2021Oh my gosh, where do I start? I don’t know how to organize my thoughts so I’ll just throw them out!
I have never felt so understood. Some of his case studies felt like they were talking about me. But yet - I read about un-relatable, unimaginable auras and symptoms. Migraines are truly bizarre.
I was shocked to read that migraines have been studied for hundreds/thousands of years and yet we still only partially understand them. Sadly, this book didn’t give any magic formula for curing or preventing migraines - but I’m not surprised based on my personal experience. It’s disheartening but validating.
I wish I would have had the opportunity to have Dr Sacks as my doctor. I have struggled with classical migraines for over 20 years and persistent/chronic common migraine for almost 6 years, and I have never spent more than 10 minutes at a time with a neurologist just taking about my experience. I am so jealous of his clients; that he truly was interested in making sense of what his patients were going through and see things from their perspective.
Part of the reason this took me almost a year to read is because there is a huge section in the middle where, in very clinical language, he describes theories of migraine causes and then why those theories were not correct. I wish there was a version of this book for non-doctors that only focused on what’s going on, why, and what (if anything) can be done. Because that stuff is fascinating and helpful and IN this book, but I wonder how many people like me give up because of the parts that are over our heads.
The most eye-opening part for me was when he theorized about the physiological, biological, and psychological reasons behind migraines. Some people have very specific “triggers”, but mine have always been vaguer. Sometimes this or that is a trigger and sometimes it’s not - that would drive me crazy. But thinking that there are a bunch of different things contributing to maybe my body physiologically NEEDING a “time out” or an extended period of recovery/sleep — and maybe migraine being a way to MAKE me pause so my body can get what it needs — that’s been a game changer personally and will no doubt inform my treatments and preventative strategies.
All in all, even though it’s been almost 30 years since it was last updated, I found this book extremely insightful and interesting. I hope some migraine professional takes it and updates it again in Dr Sacks’ honor!!
I’m very grateful for Dr Sacks’ research on migraines. He does mention that migraines don’t get the medical attention they should because the negative physical effects are temporary — these same symptoms are indicative of stroke, gastrointestinal problems, tumors, etc., but then they disappear. Unfortunately I get how the money goes towards those other serious, long-lasting problems... and then we migrainers just intermittently suffer time after time. In more recent years, I think groups have better quantified the “cost” of migraines to the economy with migraine sufferers missing work, and so more research is going towards migraine prevention/treatment, but we still have a long way to go.
I have never felt so understood. Some of his case studies felt like they were talking about me. But yet - I read about un-relatable, unimaginable auras and symptoms. Migraines are truly bizarre.
I was shocked to read that migraines have been studied for hundreds/thousands of years and yet we still only partially understand them. Sadly, this book didn’t give any magic formula for curing or preventing migraines - but I’m not surprised based on my personal experience. It’s disheartening but validating.
I wish I would have had the opportunity to have Dr Sacks as my doctor. I have struggled with classical migraines for over 20 years and persistent/chronic common migraine for almost 6 years, and I have never spent more than 10 minutes at a time with a neurologist just taking about my experience. I am so jealous of his clients; that he truly was interested in making sense of what his patients were going through and see things from their perspective.
Part of the reason this took me almost a year to read is because there is a huge section in the middle where, in very clinical language, he describes theories of migraine causes and then why those theories were not correct. I wish there was a version of this book for non-doctors that only focused on what’s going on, why, and what (if anything) can be done. Because that stuff is fascinating and helpful and IN this book, but I wonder how many people like me give up because of the parts that are over our heads.
The most eye-opening part for me was when he theorized about the physiological, biological, and psychological reasons behind migraines. Some people have very specific “triggers”, but mine have always been vaguer. Sometimes this or that is a trigger and sometimes it’s not - that would drive me crazy. But thinking that there are a bunch of different things contributing to maybe my body physiologically NEEDING a “time out” or an extended period of recovery/sleep — and maybe migraine being a way to MAKE me pause so my body can get what it needs — that’s been a game changer personally and will no doubt inform my treatments and preventative strategies.
All in all, even though it’s been almost 30 years since it was last updated, I found this book extremely insightful and interesting. I hope some migraine professional takes it and updates it again in Dr Sacks’ honor!!
I’m very grateful for Dr Sacks’ research on migraines. He does mention that migraines don’t get the medical attention they should because the negative physical effects are temporary — these same symptoms are indicative of stroke, gastrointestinal problems, tumors, etc., but then they disappear. Unfortunately I get how the money goes towards those other serious, long-lasting problems... and then we migrainers just intermittently suffer time after time. In more recent years, I think groups have better quantified the “cost” of migraines to the economy with migraine sufferers missing work, and so more research is going towards migraine prevention/treatment, but we still have a long way to go.
May 19, 2019
Every migraineur should read this book. Sacks discusses migraine in terms of case histories, neurology, psychology, and the history of medicine. His account of migraine auras engage with religious figures and research on hallucinogens. The case histories are numerous and rich, and his digests of clinical experience are detailed, organized, and humane. You won't find some magic treatment for migraine in here -- there is none -- but you'll get a rich, historically informed, and sympathetic account of migraine from a sensitive and acute physician-writer.
Note: the book was first published in 1970, and revised by Sacks in 1992. For all that, the pharmacology is only a bit out of date, and the neurology still appears to be current (to my admittedly non-expert and cursory attempt to learn of significant new developments). In every other respect, I doubt that anyone will do a better treatment of migraine experience for decades.
Note: the book was first published in 1970, and revised by Sacks in 1992. For all that, the pharmacology is only a bit out of date, and the neurology still appears to be current (to my admittedly non-expert and cursory attempt to learn of significant new developments). In every other respect, I doubt that anyone will do a better treatment of migraine experience for decades.
January 5, 2024
As a 'migraineur' I personally found this book enjoyable, reading about familiar symptoms and experiences (while also feeling glad I didn't experience the mosaic vision that some do)
Although for those merely interested in increasing their knowledge, and even in fact for myself with a personal interest the book meanders considerably. I wasn't exactly sure what the difference between Part's II and III were, and it felt like there was much repetition across chapters (especially the concluding chapter)
The section on psychological causes for migraines was hilarious (I must have emotional constipation...) although even updated in the 90s (not that long ago science-wise) feels pretty dated.
2023 update: I reread this book this year - not much to update on other, than I do love Sack's style of sympathetic person centred perspectives
Although for those merely interested in increasing their knowledge, and even in fact for myself with a personal interest the book meanders considerably. I wasn't exactly sure what the difference between Part's II and III were, and it felt like there was much repetition across chapters (especially the concluding chapter)
The section on psychological causes for migraines was hilarious (I must have emotional constipation...) although even updated in the 90s (not that long ago science-wise) feels pretty dated.
2023 update: I reread this book this year - not much to update on other, than I do love Sack's style of sympathetic person centred perspectives
June 27, 2010
I just briefly started reading this book on the subway, until I feared the swaying motion, screeching, piercing lights, incessant babble, and ear-splitting singing of the blind beggar might bring on a migraine.
We can't blame it on florescent lighting, traffic jams, or the office because it’s been around at least since Hippocrates.
If you experience migraines, either occasionally or constantly, this book can be an eye-opener to better understanding and coping with this mysterious complex event.
Hint: having all your teeth (or other organs) removed and/or blood-letting probably won’t be affective. But some strong coffee and/or a shrink might be helpful!
And go ahead and draw those blinking geometric lights... aura art seems to be all the rage.
We can't blame it on florescent lighting, traffic jams, or the office because it’s been around at least since Hippocrates.
If you experience migraines, either occasionally or constantly, this book can be an eye-opener to better understanding and coping with this mysterious complex event.
Hint: having all your teeth (or other organs) removed and/or blood-letting probably won’t be affective. But some strong coffee and/or a shrink might be helpful!
And go ahead and draw those blinking geometric lights... aura art seems to be all the rage.
February 20, 2018
At one time may have been cutting edge. I did enjoy the historical aspects of it, although Mr. Sacks is not a gifted writer so you slog and swamp through his writing. The information is outdated and you will not find a cure or a treatment plan. Anyone who says Mr. Sacks is empathic to the migraine sufferer, has never truly had a migraine. He does what doctors have done for centuries and subtly blames the patient, or implies they are a little crazy or off in "the head". Read it by all means, but than get some real information from a headache clinic or a neurologist & get the real help you need.
January 4, 2013
Anyone who has the misfortune to suffer from migraines NEEDS to read this book! It explains so much. Sadly ... not really how to actually be CURED of them, but a fascinating read anyway, and it's always good to know you're not alone. Especially if you suffer from Cyclical Vomiting Syndrome, like I do, and it explains the links with sickness extremely well. Oliver Sacks is always a pleasure to read anyway, and has a lovely, readable style, despite dealing with complicated chemical explanations etc.
June 26, 2013
Migraine is a helpful book for people who suffer from migraines. It has full of rich detailed explanations and case studies. Dr. Sacks is wonderful neurologist who is a migraine sufferer himself. I was amazed at how many symptoms a migraine sufferer can have besides the actual headache
I also suffer from migraines and have found that many of the weird experiences I have had are part of the migraine syndrome.
In another of his books, Hallucinations, Dr. Sacks details Alice in Wonderland syndrome -which are symptoms I had frequently as a child - but no one understood what I was talking about. I think they thought I was making it up. I have a few occurrences in later years. I also have experienced optical migraines - auras - recently
This book, Migraine, is a bot technical in places - for those of us who are not medical doctors or neurologists - but I found that I could still follow what was being said. I wish I had read it years ago when I was experiencing frequent headaches
I also suffer from migraines and have found that many of the weird experiences I have had are part of the migraine syndrome.
In another of his books, Hallucinations, Dr. Sacks details Alice in Wonderland syndrome -which are symptoms I had frequently as a child - but no one understood what I was talking about. I think they thought I was making it up. I have a few occurrences in later years. I also have experienced optical migraines - auras - recently
This book, Migraine, is a bot technical in places - for those of us who are not medical doctors or neurologists - but I found that I could still follow what was being said. I wish I had read it years ago when I was experiencing frequent headaches
January 20, 2018
It is always a bit of a slog reading Sacks, because he does not dumb down the complexities of his own hard won understanding. Migraine is a prime example of that: his range of thought, his elaboration of detail and historical reference is immense, and often confusing to those of us who are less acquainted with all the disciplines he employs. This is not a page-turner but a labor of thinking.
At times I was tempted to give it up, seeing it as too indulgent, to specific an area of study for a layman, but, as always, I ended up being glad I persisted.
If, however, you are not passionate in your curiosity about perception itself, you probably won't want to invest the time and concentration this volume demands. If the evolution of comprehension and its mechanisms is exciting to you, this book with leave you intrigued and amazed.
At times I was tempted to give it up, seeing it as too indulgent, to specific an area of study for a layman, but, as always, I ended up being glad I persisted.
If, however, you are not passionate in your curiosity about perception itself, you probably won't want to invest the time and concentration this volume demands. If the evolution of comprehension and its mechanisms is exciting to you, this book with leave you intrigued and amazed.
May 25, 2023
There is something amusing about getting my first full-assault migraine in two months as I read Sacks's book Migraine. I suppose my brain wanted to sadistically illustrate the text--if so, grand job! This book is not an easy read, even when one can read with both eyes. There is heavy medical jargon. Even so, it proved to still be an informative work to skim, and I did pick up a few new terms to employ. Though the book is certainly out of date in relation to new medical interventions, it is still powerful because it presents a sort of literary history of the migraine going back to writers of ancient Greece. I was amazed to see how much I had in common with other sufferers--and how much worse my plight could be. (I was horrified that some people, when seeing visual distortions, in truth believed that chunks of their reality were gone.)
February 2, 2023
I have these. They suck but knowing is half the battle right?
I read this in my teens and it inspired an obsession with the brain that has never subsided. If you haven't read Oliver Sacks, you are boring.
I read this in my teens and it inspired an obsession with the brain that has never subsided. If you haven't read Oliver Sacks, you are boring.
February 28, 2016
Her ne kadar tıbbi eğitim almamış okuyucuların da anlayacağı bir dille yazılmaya çalışılmışsa da ben okurken epey yoruldum. Fakat yine de migrene ve doğasına dair birçok fikir kazandırıyor (yani öyle her başı ağrıyan migren değilmiş).
August 30, 2020
Primer Libro de Oliver Sacks. Muy técnico, diferente a sus escritos posteriores. Tercera edición revisada, el original data de 1970, y parece escrita para Licenciados en Medicina. Árduo y complicado, al final lo he disfrutado. Ahora a por Despertares, su segundo libro, mucho más generalista. :-)
September 5, 2015
I don't suffer from migraines, so reading a book about them should have held no interest for me. And yet...the late great Dr. Sacks has managed to enlightening, inform, and entertain me again!
January 19, 2016
I didn't finish this before it had to go back because I just couldn't get into it.
I get the feeling that maybe I've read it before?
Just did not enjoy this as much as the other Oliver Sacks books.
I get the feeling that maybe I've read it before?
Just did not enjoy this as much as the other Oliver Sacks books.
December 15, 2020
Bez pārspīlējumiem teikšu, ka izcili daudz no tā, ko mēs mūsdienās zinām par migrēnu tās holistiskajā redzējumā, ir Oliver Sacks vārdos nosauktais. Precīzi, pilnīgi, iejūtīgi un visaptveroši. Saprotami un iedvesmojoši.
December 22, 2025
More of a textbook rather than a layman’s read. But informative and interesting.
December 25, 2020
Not worth reading, sadly. I really enjoy Oliver Sacks' other books (awakening, man/wife/hat..) - a great blend of narrative style and surprising cognitive science. Picked this one up on a whim as I've lived with significant migraine patterns for the last decade and was hoping for some new perspective.
What I liked:
1. It's always fun when you read something that resonates on a frequency you previously felt was a singularly personal experience. (the mass-market neuroses of didion or knausgaard, etc.) Migraines by their nature are pretty private and isolating, and it can be easy despite all knowledge otherwise to feel like it's you against the world. Sacks does a nice job painting a resonant account of migraines, building on thousands of clinical anecdotes from his decades as a practicing neurologist. Sacks lays out the common structure of migraines and I got to see my own experience validated a bit in that pattern.
2. Some fun history about how far back in the human record we have written account of migraines (egypt, rome, etc) and famous figures who lived with them (caeser and napolean through to seurat and virginia wolfe).
3. Discussion of migraines as composites, with deep detail into associated symptoms that cooccur and can even manifest so strongly that you have migraines w/o headaches.
What I did not like:
- This is closer to a medical text than a consumer narrative. It's structured in many places like a literature review or meta-research paper, with a distracting reliance on historical paper quotations.
- Dated. Written in the 70's and lacks all the interesting progress over last 40 years, particular on pharmacology and diet.
What I liked:
1. It's always fun when you read something that resonates on a frequency you previously felt was a singularly personal experience. (the mass-market neuroses of didion or knausgaard, etc.) Migraines by their nature are pretty private and isolating, and it can be easy despite all knowledge otherwise to feel like it's you against the world. Sacks does a nice job painting a resonant account of migraines, building on thousands of clinical anecdotes from his decades as a practicing neurologist. Sacks lays out the common structure of migraines and I got to see my own experience validated a bit in that pattern.
2. Some fun history about how far back in the human record we have written account of migraines (egypt, rome, etc) and famous figures who lived with them (caeser and napolean through to seurat and virginia wolfe).
3. Discussion of migraines as composites, with deep detail into associated symptoms that cooccur and can even manifest so strongly that you have migraines w/o headaches.
What I did not like:
- This is closer to a medical text than a consumer narrative. It's structured in many places like a literature review or meta-research paper, with a distracting reliance on historical paper quotations.
- Dated. Written in the 70's and lacks all the interesting progress over last 40 years, particular on pharmacology and diet.
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