Other disturbances of higher cortical functions

Achromatopsia (loss of colour vision)

"I thought I did not get aura with my migraines; no seeing stars or sparkly, flashy patterns. But I do - sometimes - get tunnel vision and after that the world seems glossy, stylized, black&white (sometimes) or it gets either very sharp or very fuzzy. I though it was just some strange thing my eyes/brain was doing, but could this be the aura I have heard so much about?"

(Anna Decker, Newsgroups: alt.support.headaches.migraine, Subject: Aura?????, May 17, 2000)

A further cases of achromatopsia occurring as migraine aura symptom has been reported by Lawden and Cleland (1993).

Allochiria

Allochiria (also called allocheiria) is a form of dyschiria in which, if one extremity is stimulated, the sensation is referred to the opposite side.

"my normal aura is tingling around my mouth and cheeks, but the weirdest one I ever had was where the sensations in my hands were switched -- I felt everything that my right hand was feeling in my left hand, and vise versa. Example, I was resting my head on my left hand, but felt the pressure in my right hand."

(jensternal, Livejournal for Support Group for Migraine Sufferers, Subject: Weirdest migraine aura, November 23, 2005)

Balint's syndrome

Shah and Nafee (1999) described "a patient with recurrent episodes of migraine in whom headache was preceded by a constellation of visual symptomatology which constituted salient components of Balint's syndrome. This syndrome, consisting of a triad of simultagnosia, optic ataxia, and oculomotor apraxia, is seen with bilateral lesions of occipitoparietal cortices affecting connections between visual cortical regions and the frontal eye field."

Chromatopsia (distortion of colour vision)

"Aura can vary soooo much from person to person... Sometimes my surrounding take on an odd orange/yellow color before a migraine strikes."

(Mary, Newsgroups: alt.support.headaches.migraine, Subject: Aura's and Warning Signals????, December 3, 1997)

Prosopagnosia (agnosia for faces)

"Yep I get them - yuk: Lots of visual disturbances with coloured zig-zags that flash with tunnel vision. For me, the first sign of an impending migraine is an inability to recognise faces. At that point I go straight to bed with neurofen (iboprofen) or aspirin in a darken room and can usually sleep through the entire event (about 8 hours). If I don't do this, I get a splitting headache behind the eyes much as you describe. I get nauseous and sometimes vomit. My speech centres get damaged and I can't seem to put words together properly - for example one time I wanted to say 'Jamie and Carey' who are two friends of mine but all I could put together was 'Shamie and Arey' or variants of that - sounds weird but I just don't seem to have proper control over whatever language centres are involved. I also get paraesthesia and other neurological stuff."

(Paul Jones, Newsgroups: alt.support.mult-sclerosis, Subject: Migraines, August 18, 2000)

Further cases of prosopagnosia occurring as migraine aura symptom have been reported by Lawden and Cleland (1993) and Martins and Cunha e Sa (1999).

"Interestingly enough, migraine headaches can be a cause of temporary prosopagnosia - my father experienced this some years ago and described it as something like "seeing all the bits that make up a face - eyes, nose, ear, chin - but not in any particular arrangement that said face".

(fractalid, monkeyfilter, August 10, 2004)

Alice's encounter with Humpty Dumpty - Illustration from Lewis Carroll, Through the Looking-Glass, 1872 (see here)

Right-sided hemianopia and prosopagnosia of one's own face

"The pattern changed on Friday. I had two 'normal' migraines in quick succession on Friday morning, and then on Saturday morning I was checking my hair in my mirror and I couldn't quite see myself - I had trouble perceiving the right hand side of my face, and it felt as if I was looking at someone I didn't recognise. That sensation is still there (Sunday afternoon) and I have slight numbness in my hands and neck. I can see detail perfectly well, but I can't seem to take in the overall picture of what I'm looking at. As this is so out of type, and I have a history of stroke in the family, I've started to get worried. Before I go running off in a flat spin to my doctor, does this sort of thing ring a bell with anyone here?"

(Karen Traviss, Newsgroups: alt.support.headaches.migraine, Subject: Change in types of migraine?, June 30, 2002)

References

Larner AJ . Lewis Carroll's Humpty Dumpty: an early report of prosopagnosia? J Neurol Neurosurg Psychiatry 2004; 75: 1063.
Larner A. The neurology of 'Alice'. ACNR 2005; 4 (no. 6): 35-36.
Lawden MC, Cleland PG. Achromatopsia in the aura of migraine. J Neurol Neurosurg Psychiatry 1993; 56: 708-709.
Martins IP, Cunha e Sa M. Loss of topographic memory and prosopagnosia during migraine aura. Cephalalgia 1999; 19: 841-843.
Morath GP. Prosopagnosie als Symptom einer Migräneaura. Eine Falldarstellung mit Literaturübersicht. Dissertation, Medizinische Fakultät Universität Zürich, März 2004.
Sandor P, Morath G, Hess K, Kaube H, Agosti R, Regard M. Prosopagnosia as symptom of migraine with aura: a case report. Cephalalgia 2006; 26: 345-348.
Shah PA, Nafee A. Migraine aura masquerading as Balint's syndrome. J Neurol Neurosurg Psychiatry 1999; 67: 554-555.

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