| List of Illustrations | xiii |
| Preface to the Revised (1992) Edition | xv |
| Preface to the Original (1970) Edition | xvii |
| Acknowledgments | xix |
| Foreword | xxi |
| Historical Introduction | 1 |
Part I | The Experience of Migraine | |
| Introduction | 11 |
Chapter 1 | Common Migraine | 13 |
| Introductory Comments | |
| Headache | |
| Nausea and Associated Symptoms | |
| Facial Appearance | |
| Ocular Symptoms | |
| Nasal Symptoms | |
| Abdominal Symptoms and Abnormal Bowel-Action | |
| Lethargy and Drowsiness | |
| Dizziness, Vertigo, Faintness and Syncope | |
| Alterations of Fluid Balance | |
| Fever | |
| Minor Symptoms and Signs: Pupillary Abnormalities, Horner's Syndrome, Bradycardia, Multiple Ecchymoses, Whitening of Hair, etc. | |
| Organic Irritability and Photophobia | |
| Mood-Changes | |
| Symptom-Constellations in Common Migraine | |
| The Sequence of a Common Migraine: Prodromal Symptoms, Modes of Resolution, Post-Migrainous Rebound | |
| Concluding Comments | |
| Postscript (1992) | |
Chapter 2 | Migraine Equivalents | 34 |
| Introductory Comments | |
| Cyclic Vomiting and Bilious Attacks | |
| Abdominal Migraine | |
| Periodic Diarrhoea | |
| Periodic Fever | |
| Precordial Migraine | |
| Periodic Sleep and Trance-States | |
| Periodic Mood-Changes | |
| Menstrual Syndromes | |
| Alternations and Transformations of Migraine | |
| Borderlands of Migraine: Vagal Attacks, Faints, Reactions to Heat, Exhaustion, Passive Motion, Alcohol, etc. | |
| Alternations and Concomitances with other Disorders: Asthma, Angina, Laryngospasm, Sleep-Disorders, Peptic Ulcer, Ulcerative Colitis, Crohn's Disease, Psoriasis, etc. | |
| Differential Diagnosis of Migraine Equivalents | |
| Concluding Comments | |
Chapter 3 | Migraine Aura and Classical Migraine | 51 |
| Introductory Comments: Historical Descriptions of Migraine Aura | |
| Specific Visual Hallucinations: Phosphenes and Elementary Hallucinations, Varieties of Migraine Spectra, Characteristics of Scintillating and Negative Scotomata | |
| Specific Tactile Hallucinations: Paraesthesiae, Anaesthesia | |
| Other Sensory Hallucinations: Auditory, Olfactory, Taste, Epigastric, Motor, Vertiginous, etc. | |
| Pseudo-objectivity of Migraine Hallucinations | |
| General Alterations of Sensory Threshold | |
| Alterations of Consciousness and Postural Tone | |
| Specific Motor Disorders: Weakness, Paralyses, Spasms, Seizures | |
| Alterations of Affect and Mood | |
| Disorders of Higher Integrative Functions: Complex Visual Distortions (Micropsia and Macropsia, Mosaic and Cinematographic Vision, Metamorphopsias, Visual Agnosias, etc.) | |
| Complex Apraxias, Agnosias, and Distortions of Body-Image | |
| Aphasias | |
| Time-Distortions, Deja Vu, and Forced Reminiscence | |
| Dreamy States | |
| Migrainous Deliria and Psychoses | |
| Illustrative Case-Histories | |
| Comments on the General Structure of Migraine Aura: Its Differential Diagnosis and Distinction from Epilepsies | |
| Classical Migraine | |
| Postscript (1992): The Angst of Scotoma | |
Chapter 4 | Migrainous Neuralgia ("Cluster Headache")--Hemiplegic Migraine--Ophthalmoplegic Migraine--Pseudo-Migraine | 99 |
| Migrainous Neuralgia: Synonyms, Typical Features, Illustrative Case-Histories | |
| Hemiplegic and Facioplegic Migraine: Typical Features, Possible Mechanisms of Attack, Case-Histories | |
| Ophthalmoplegic Migraine | |
| Pseudo-Migraine: Organic Lesions Simulating Migraine | |
| Permanent Neurological or Vascular Damage from Migraine | |
Chapter 5 | The Structure of Migraine | 109 |
| Introductory Comments, Components and Functional Levels of Migraine, Psychophysiological Stages of Migraine, General Characteristics of Migraine: Relation to Sleep, Epilepsy, etc. | |
Part II | The Occurrence of Migraine | |
| Introduction | 117 |
Chapter 6 | The Predisposition to Migraine | 119 |
| Introductory Comments | |
| Overall Incidence of Migraine | |
| Familial Occurrence and Inheritance of Migraine | |
| Signs of Migrainous Constitution | |
| Migraine Diathesis in Relation to Other Disorders | |
| Migraine in Relation to Age | |
| General Discussion and Conclusions | |
Chapter 7 | Periodic and Paroxysmal Migraines | 133 |
| Migraine and Other Biological Cycles | |
| Time Between Attacks: Relation Between Frequency and Severity of Attacks | |
| Immunity Between Attacks | |
| Signs of Approaching Attacks | |
| Intrinsic and Extrinsic Determinants of Periodicity | |
| Conclusions: The Notion of Idiopathy | |
| Postscript (1992) | |
Chapter 8 | Circumstantial Migraine | 140 |
| Classification of Provocative Circumstances | |
| Arousal Migraines: In Response to Light, Noise, Odours, Weather, Exercise, Excitement, Violent Emotions, Pain, Drugs, etc. | |
| Slump Migraines: In Relation to Eating, Fasting, Heat, Fever, Passive Motion, Exhaustion, Drugs (Alcohol, Reserpine, etc.) | |
| Nocturnal Migraines, and Relation of Attacks to Dreams and Nightmares | |
| Migraine Aura in Response to Flickering Light, Patterned Stimuli, and Visualisation of Scotomata | |
| Miscellaneous Determinants: Food, Constipation, Menstrual Cycles, Hormones, Allergies, etc. | |
| Self-Perpetuation of Migraines | |
| Provocation of Attacks in Relation to "Tuning" and Homeostatic Limits Within Nervous System | |
Chapter 9 | Situational Migraine | 164 |
| Migraine in Relation to Intolerable Emotional Stress | |
| Preliminary Comments on "Migraine Personality" and Relation of Attacks to Repressed Hostility | |
| Case-Histories Illustrating Wide Range of Situations and Character-Types in which Repeated Migraines May Occur | |
Part III | The Basis of Migraine | |
| Introduction | 175 |
| Clarification of the Term "Cause" in Relation to Migraine | |
| Necessity to View Migraine in Three Ways: as a Process in the Nervous System, as a Reaction to Certain Stimuli, and as a Particular Form of Experience | |
Chapter 10 | Physiological Mechanisms of Migraine | 178 |
| Historical Introduction: Classical Theories (Humoral and Sympathetic), Vascular and Vasomotor Theories of the Nineteenth Century | |
| Critiques of These | |
| Liveing's Theory of "Nerve Storms" | |
| Current theories of Migraine Mechanisms and their Supporting Data | |
| Vasomotor Theories (Latham-Wolff) Considered and Disputed | |
| Chemical Theories of Migraine, with Particular Reference to Acetylcholine, Histamine, and Serotonin: Critique of These | |
| Electroencephalographic Findings in Migraine: Notion of "Dysrhythmic Migraine," and of "Spreading Depression" in Relation to Migraine | |
| Limitations of Current Theory and Data | |
Chapter 11 | The Physiological Organisation of Migraines | 193 |
| Introductory Comments | |
| Migraines as Polymorphous Parasympathetic or Trophotropic Events | |
| Migraine as a Slow Form of Centrencephalic Seizure | |
| Consideration of Visual Hallucinations in Migraine and Their Cortical Basis | |
| Hierarchical Organisation of Migraines, and Their Relationship to other Paroxysmal Events | |
| Migraine Considered as a "Neural Task," with Fixed Ends and Variable Means | |
Chapter 12 | Biological Approaches to Migraine | 205 |
| Migraine Considered as a Special Form of Protective Behaviour | |
| Its Affinities to other Passive Reactions to Threat (Passive Fear, "Freezing," Sham Death, Pathological Sleep, Fainting, etc.) | |
| Contrast of These Reactions to Fight-Flight Responses | |
| Concept of the Migraine Archetype, and its Differentiation in Response to Human Needs and Human Nervous Systems | |
Chapter 13 | Psychological Approaches to Migraine | 211 |
| Necessity of Considering Migraines as Experiences to which Emotional Values are Attached. Common Uses of Migraines: Recuperative, Regressive, Encapsulative, Dissociative, Aggressive, and Self-Punitive Attacks | |
| Mechanisms of Psychosomatic Illness in Reference to Migraine | |
| Migraine Considered as a "Vegetative Neurosis" and as a Special Form of Conversion Reaction | |
| Attachment of Symbolic Value to Particular Symptoms of Migraine | |
| Migraine Considered as an Archaic Form of Bodily Language | |
| Conclusions | |
Part IV | Therapeutic Approaches to Migraine | |
| Introduction | 229 |
Chapter 14 | General Measures in the Management of Migraine | 230 |
| Introductory Comments: Approach to the Patient and Role of the Physician | |
| General Health Measures and Avoidance of Provocative Circumstances | |
| Forms and Uses of Psychotherapy | |
| Definition of Therapeutic Goals | |
| Reasons for Success and Failure in the Treatment of Migraine | |
Chapter 15 | Specific Measures During and Between Attacks | 238 |
| Introductory and Historical Comments | |
| Drugs of Specific Use During Acute Attacks: Ergotamine, its Uses and Contraindications, Caffeine, Parasympathetic Blockers (Belladonna, etc.), Sympathomimetic Drugs (Amphetamines, etc.) | |
| Symptomatic Drugs: Analgesics, Anti-Emetics, etc. | |
| Miscellaneous Drugs: Legitimate and Otherwise General Measures in the Acute Attack | |
| Management of "Status Migrainosus" | |
| Drugs Employed in the Prevention of Migraine Attacks: Methysergide (Sansert, Deseril), its Uses and Dangers | |
| Use of Ergotamine Prophylactically | |
| The Role of Sedatives, Tranquillisers, Anti-Depressants, etc. | |
| Other Forms of Medication | |
| The Uses of Placebos | |
| Histamine "Desensitisation" | |
| Allergic "Desensitisation" | |
| Hormone Preparations, Their Abuses and Dangers | |
| The Place of Surgical Procedures | |
| Conclusions | |
Chapter 16 | Recent Advances in the Treatment of Migraine | 256 |
Part V | Migraine as a Universal | |
Chapter 17 | Migraine Aura and Hallucinatory Constants (with Ralph M. Siegel, PH.D.) | 273 |
| Introduction | |
| Types or Levels of Hallucination | |
| Hallucinatory Constants | |
| Mechanisms of Hallucination | |
| Self-Organising Systems | |
| A New Model of Migraine Aura | |
Appendix I | The Visions of Hildegard | 299 |
Appendix II | Cardan's Visions (1570) | 302 |
Appendix III | Remedies Advised by Willis (1672), Heberden (1801) and Gowers (1892) | 304 |
| Glossary of Case-Histories | 307 |
| Glossary of Terms | 311 |
| Bibliography | 319 |
| Index | 329 |