Exploring the visual hallucinations of migraine aura: the tacit contribution of illustration.
Exploring the visual hallucinations of migraine aura: the tacit contribution of illustration.
复制标题
探索偏头痛先兆的视觉幻觉：插图的默认贡献。
DOI：
10.1093/brain/awl348
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
G. Schott
中科院分区：
文献类型：
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作者：
G. Schott
偏头痛的视觉光环是一种主观现象，偏头痛患者所经历的必然是其他人无法获得的。然而，幸运的是，患者偶尔可以通过图形表示的方式揭示所看到的东西，从而打开一个原本关闭的“窗口”，以了解暂时功能失调的大脑。本文探讨了插图对理解为视觉光环服务的机制所做的独特贡献。最能说明问题的是那些记录和分析偏头痛发作期间暗斑，特别是不断扩大的强化光谱的极少数科学家所做的说明。只有通过这样的例子，许多幻觉的统一性质才得以证明。因此，我们可以得出结论，在枕叶皮层中产生幻觉的过程很可能是类似的统一的。组成强化谱的之字形的精确形式，其闪烁的外观，特别是外周扩散的速度，所有这些都完全依赖于图形显示来阐明，使我们能够得出一些潜在的病理生理机制的结论，包括可能发生的扩张性皮层抑制的参与。插图在揭示不常见的，有时甚至是奇怪的，如果不是奇怪的话，视觉幻觉的形式表明，在某些情况下，外脑区和颞叶的参与导致了偏头痛的先兆。插图在鉴别诊断中也有价值，描绘由各种非偏头痛原因引起的其他形式的视幻觉。插图，特别是在发作期间，提供了一个不寻常的，很少使用但强大的工具，它独特地允许患者的主观视觉体验为客观分析提供信息。反过来，这一分析导致了对偏头痛先兆的一些大脑紊乱的深入了解。
The visual aura of migraine is a subjective phenomenon, and what the migraineur experiences is necessarily inaccessible to others. Fortunately, however, the sufferer can occasionally reveal what is being seen by means of graphic representation, enabling an otherwise closed 'window' to be opened on the transiently dysfunctioning brain. This article explores the unique contribution that illustration has made to understanding mechanisms subserving the visual aura. The most revealing illustrations are those made by the very few scientists who have recorded and analysed the scotomas, and in particular the expanding fortification spectra, experienced during their migraine attacks. It is solely through illustrations such as these that the uniform nature of many of these hallucinations has been demonstrated. As a result, it follows that there is likely to be a similarly uniform repertoire of processes that generate the hallucinations in the occipital cortex. The precise form of the zigzags that comprise the fortification spectrum, their shimmering appearance, and in particular the speed of the peripheral spread, all of which are entirely dependent on graphic display for their elucidation, enable conclusions to be reached about a number of the underlying pathophysiological mechanisms, including the involvement of spreading cortical depression, that likely occur. Illustration has been pivotal too in revealing uncommon and sometimes curious, if not bizarre, visual hallucinations, the forms of which suggest that extrastriate and temporal lobe involvement contributes to migraine aura in some instances. Illustration can also be valuable in differential diagnosis, depicting other forms of visual hallucination which result from a variety of non-migrainous causes. Illustration, particularly when made during the attack, provides an unusual, little used but powerful tool which uniquely allows the sufferer's subjective visual experiences to inform objective analysis. In turn, this analysis leads to insights into some of the cerebral disturbances which subserve migraine aura.