After my migraines greatly escalated in frequency over the past year, I decided that it would be wise to get more information, hence the reading of this classic. First published in 1970, and revised in 1985 and 1992, Migraine contains a wealth of facts, case studies, ideas, and speculation relating to the complex, elusive phenomenon of migraine. Perhaps I should say 'phenomena', since no two migraines seem to be the same. Dr. Sacks has treated over 1000 migraineurs, and appears to have read and studied everything, ancient and modern, relating to migraine. I learned a tremendous amount about what afflicts me by reading this book, and I also unlearned some of what I thought I knew, such as that migraine aura is caused by a vasoconstriction, which is followed by a pain-producing vasodilatation (i.e. the discredited vasomotor theory of migraine). But, as with any good book written by an inspired, thoughtful author, Migraine is about much more than its principle subject. Dr. Sacks is so well read and so fundamentally curious and enthralled by the universe he finds himself in, that the reader cannot help but be sucked along in his jet stream, learning about such things as the visions of Hildegard of Bingen, Dostoyevsky's epileptic ecstasies, Novalis' dictum 'every disease is a musical problem; every cure a musical solution', as well as chaos theory and self-organising systems. I found the only weak chapter to be the one entitled 'Psychological Approaches to Migraine'. It would be better entitled 'Psycho-analytical Approaches to Migraine' since in it Dr. Sacks seems to accept and promote the most bizarre and outrageous of the unscientific ravings of the 'Viennese witch doctor'. Oh well.
The many case studies quoted in Migraine are illuminating, invaluable and make for fascinating reading. It is important for the migraineur, as well as for family and therapeutic practitioners, to realise that there is much more to migraine that just the pain of the headache. Dr. Sacks' description of the various sources of depression that can accompany migraine was particularly valuable to me. Depression may not only be in response to the pain, nausea and oppression of a headache, it can be an independent symptom that accompanies all of the other symptoms concurrently.
Although, for a non-medical person, Migraine can be tough sledding in parts, Dr. Sacks is a wonderful, elegant, and inspired writer. There is a very helpful and considerate glossary supplied, in addition to an excellent index. I found Migraine a joy to read and only hope that Dr. Sacks can find time in his busy life to grace us with a new updated edition.