Disturbances of the body image affecting its position in space

Following the classification of body image disturbances from Lukianowicz (1967), one category of body image disturbances that may occur as migraine aura symptoms can be labeled as disturbances of the body image affecting its position in space, e.g. sensations of levitation, floating, falling or sinking.

"As the heading implies, the subject experiences an apparent movement of his body in space. The direction of this movement may be various, although most often it seems to be either upward or downward. It seems that sporadic kinesthetic sensations are not uncommon in entirely normal subjects, particularly in the drowsy state before falling asleep..., when they represent the kinetic variety of the hypnagogic imagery..."

(Lukianowicz, 1967, p. 39)

In migraine sufferers, such body image disturbances affecting its position in space may be experienced as aura symptoms (either being associated with headaches or occurring in isolation as migraine aura without headache) in the awake state or during dreams, with the body image disturbance sometimes being carried over into the awake state after awakening.

If such body image disturbances occur in a migraineur whilst lying in bed in the dark, trying to fall asleep, it is difficult to tell whether the experience represents a hypnagogic hallucination or a migraine aura without headache, a differential diagnosis suggested by the following self-report from a male migraineur who "used to have bad ocular headaches when I was young, but not in many years. My mother and matrilineal aunts all suffer severe migraines."

(John D, Newsgroups: alt.dreams, Subject: Migraine auras experienced as child, December 18, 2005)

"Another time years later I was lying in bed trying to get to sleep, but I was having trouble relaxing, my mind was on a million things, work, etc. I closed my eyes and began a relaxation exercise, deep breathing, etc. I began to feel like I was growing outside the dimensions of the space I occupied. It's hard to describe. I could feel my physical body touching the sheets, pillow etc. and didn't feel like I was getting any bigger than the bed, but I had the distinct sensation of growing immensely huge at a very fast rate. At the same time, I began to feel like I was hurtling headfirst (I was lying on my back) through space at speeds faster than the speed of light. It was amazing and I can describe it as a sort of religious experience (although God didn't show up) kind of like the guy's trip at the end of 2001: A Space Odyssey. The whole experience seemed to last a very long time but when I thought myself out of it by trying to figure out what was going on, I looked at the clock and it had only been a few minutes."

(John D, Newsgroups: alt.dreams, Subject: Migraine auras experienced as child, December 17, 2005)

Sensations of levitation

"On Friday I suffered a strange [migraine] attack. When I arrived at work, around 8 AM, I had a strange sensation in my body. I felt slightly 'elevated' (for lack of a better word) and there was a tingling in my arms, especially my hands."

(Tormod Guldvog, Migraine attack, Hypography Science Forums, August 22, 2004; additions in square brackets by Klaus Podoll)

"That experience is the strangest thing that ever happened to me... I felt very lightweight and it was as if I were floating. But I knew I was not, if you know what I mean. I was sitting in my office chair but I couldn't feel it at all - it felt like I was hovering above it. Not by much, but the lack of sensation was very apparent... In a strange way it was a 'good' experience, almost like when using asthma medicines to relieve an attack - but it all happened just before the migraine kicked in so it was the other way round... Sorry if this is unclear. It happened almost a year ago."

(Tormod Guldvog, Email to Klaus Podoll, July 8, 2005) - (For the further course of this migraine attack see here).

Sensations of floating

"I woke up with a migraine this morning and now I feel like I'm in some kind of a psychogenic fugue. Objects appear to be undulating, I feel like I'm floating, my chest feels tight, and my limbs are tingling. No real pain in my head, just moving pressure."

(Cameron Felix the Cat, Livejournal for Support Group for Migraine Sufferers, Subject: your next stop, the migraine zone, January 19, 2003)

Freya Moon, Migraine, circa 2001. © 2001 Freya Moon (see here)

"Migraine is one of the early images I made and it is nice to see it is noticed after 3 or 4 years. I made it right after a really bad migraine and it expresses very well how I was feeling."

(Freya Moon, Email to Klaus Podoll, February 12, 2005)

"I have a terrible feeling in which I sense as if my head is floating in the air, when this happens I can't think, read, watch T.V., anything.... I can't tolerate light; my only recourse is to lay down, cover my head with a blanket and hope it passes... I have this condition every day... I was misdiagnosed with Menière disease and had surgery in both ears without any results... I am depressed and suicidal, with no way to earn a living..."

(Pedro Gonzalez, Ronda's Migraine Page, On-Line Migraine Journal, January 19, 2005)

In the following report from the LiveJournal for the Support Group for Migraine Sufferers, a sensation of being "just a head floating" is described as part of a
http://www.migraine-aura.org/EN/Near_death_experience.html
near-death experience
with tunnel and out-of-body experience: "maybe that's an aura. I use to get like 'tunnel vision' and I felt like I wasn't in my body. I like was just a head floating. I was told later on that it was an aura. Kinda like how some people get really hyper the day before a migraine. That is also an aura. It's like a warning our bodies give us."

(ninjakm, LiveJournal for Support Group for Migraine Sufferers, Subject: a question, January 12, 2005)

Sensations of falling

Freya Moon, Falling web, undated. © 2005 Freya Moon (see here)

"In the meantime, here is another picture I made during a mild headache: Falling web. I have noticed that my art tends to have more 'dark' aspects when my head hurts. This one was made with Poser and Paint Shop Pro. I am afraid I do not have a lot of migraines. I have more tension and cluster headaches than migraine."

(Freya Moon, Email to Klaus Podoll, February 18, 2005)

"Mine [i.e. AIWS] is usually from migraines - but it gets really bad with stress. the worst episode was last year right before finals when I thought my girlfriend was pregnant but sometimes it's just random - like I'll be sitting there just relaxing and it kicks in. driving also does it to me."

(maegman, Alice in Wonderland syndrome forum, April 4, 2005; addition in square brackets by Klaus Podoll)

"The most vivid experience I can remember was waking up one night when I was having distortions. I had a dream that night that I was falling and when I woke up, I still had the sensation of freefalling through the air."

(maegman, Alice in Wonderland syndrome forum, February 22, 2005)

"Hi, I'm new to this group... it seems like a great resource for migraine sufferers. My question is possibly related to migraines, but possibly not. About 2-3 years ago I started to have strange episodes of vertigo. I don't know if 'vertigo' is the right word. I'll try and describe it but it's hard. Out of nowhere I will get a 'jolt' or 'zap' that feels like it's going through my brain. At the same time my vision will turn on its side. I feel like I'm falling. That lasts for a split second and then my vision returns to normal. Afterwards I feel very dizzy, like I'm going to fall over, for hours. My vision is back to normal and I can walk around, but something still feels off. I've never had this happen while I had a migraine. The neurologist I saw about this couldn't find anything wrong, and suggested that it could be part of my migraines. Has anyone else had anything remotely similar to this? It scares me to death! It used to happen a lot (once a week or more) but then it gradually slowed down. Now it won't happen for 6 months or more and then out of nowhere it will strike again. I have tried to look for some kind of pattern or trigger that might cause this, but I haven't found any. Thank you for your help."

(Jessica, Newsgroups: alt.support.headaches.migraine, Subject: Vertigo?, August 11, 2005)

Sensations of sinking

"Well, it usually happens after getting into bed after a stressful day and closing my eyes. It feels like I'm being sucked into the bed, and everything around me seems overwhelming. If I open my eyes, it will continue, but the things around me are not physically bigger - they just 'feel' like it. [EDIT: and I also get the sensation of my senses not quite responding the way they should, although on inspection they seem fine] Like the ground is swallowing me up?"

(Placebo, Dream Views, Lucid Dreaming Discussion Forums, Beyond dreaming, Subject: Anyone ever get that 'spaced' feeling?, August 26, 2005)

"Yep, I used to consider it just another part of hypnagogia... however this happens before I'm anywhere close to sleeping. I can still speak to my wife, hold a conversation, etc. In addition, it has happened to me twice while sitting at my computer, typing.... I seldom get migraines. I get headaches only from e.g. sleeping too hot, and dehydrating. Nothing unusual anyway. Nope, [I have other migraine aura symptoms, e.g. the typical visual auras ...] only before a migraine. Which as I said is highly infrequent."

(Placebo, Dream Views, Lucid Dreaming Discussion Forums, Beyond dreaming, Subject: Anyone ever get that 'spaced' feeling?, August 28, 2005; additions in square brackets added by Klaus Podoll)

Other disturbances of the body image affecting its position in space

Sensations of the brain moving within the skull

"My migraines are more neurological then painful... yesterday with my most recent I SWORE I could feel my brain moving within my skull. I drove to the store and felt the reach to the steering wheel was unusually long... the pretty colored flashing lights are bothersome because they really aren't there, heh."

(jagnightwalker, Livejournal for Support Group for Migraine Sufferers, Subject: your next stop, the migraine zone, February 14, 2003)

Sensations of disclocation

"Very few people are unfortunate enough to collect the whole set of migraine symptoms. I avoid two of the classic ones, severe headache and sickness. Let's see... Aura: awareness of an impending migraine before any other symptoms. This can be a variety of things but in my case involves an unwonted level of well being and energy: feel like being able to take Tyson in two rounds. Olfactory illusion: in my case a burnt caramel smell. Pins and needles *and* numbness in left hand and left side of face. Visual illusion: I get a shimmering caterpillar that wanders slowly across my vision. With some people this is a larger arc, with jagged lines. Frequently the area inside the arc is blanked out. Hemianopia: loss of vision on one side, in my case the left, as a later stage in the attack. Blocking of memory: either/both of failure to recall very well-known information and a fixing of a single thought which cannot be got rid of. Dislocation: something approaching an out-of-body experience, a lack of identification of oneself. Post-migraine lassitude: feeling completely washed out and exhausted. Of the other common symptoms, I also miss out on light sensitivity and super-acute hearing. Mine are mainly stress triggered, but as not uncommonly, they hit most often when the stress comes off... -- CB "

(Chris Brown, Newsgroups: alt.support.headaches.migraine, Subject: What do you know about migraine?, October 8, 2000; emphasis of sentence in cursive letters by Klaus Podoll)

"Or sometimes if I'm sitting pretty still, I'll start to feel as though my body's in a different position than it really is. Sometimes I even feel like I'm sideways, but my body is still sitting up."

(char, Livejournal for Support Group for Migraine Sufferers, Subject: Tell me about your aura, October 14, 2004)

"I used to get vertigo before all my migraines.
Sometimes I my vision throbs with my pulse.
And I still get the feeling that I'm in a different position than I really am. Like I'll feel like my hands are at my sides, but they're folded in my lap. It's real bad when I feel like I'm sideways, but I'm sitting up in my chair."

(char, LiveJournal for Support Group for Migraine Sufferers, Subject: "Different" Sorts of Auras, March 8, 2005)

"My other aura I get is a sort of vertigo too, and I can only describe it as some hidden something or other smacking me across the head. It almost feels as if the room shifts or topples to the left in front of me. I end up with several minutes of disorientation (like flying cartoon birdies around my head hee) and I know I'm in for a doozy of a headache."

(jagnightwalker, Livejournal for Support Group for Migraine Sufferers, Subject: Tell me about your aura, October 14, 2004)

"Yup, sometimes I feel that way too. I can be walking through the store and feel as if I've been slapped upside the head as the room falls sideways in front of me, heh. Very disturbing."

(jagnightwalker, LiveJournal for Support Group for Migraine Sufferers, Subject: "Different" Sorts of Auras, March 8, 2005)

"Do any of you experience weirdness after your aura, but before the pain hits? I have found that I almost become 'drunk' (for lack of a better term), or at the very least… LOOPY. I'm uncoordinated, like my fingers don't want to work quite right, my perception is off a bit etc. When I'm alone and I'm feeling this, it normally leads to panic attack. But if I'm with my fiancé, it can be *almost* fun.
Not REALLY fun, but comical anyway. ...
Yea, I guess it could be considered a part of my aura itself! Normally this confusion starts about 10-15 minutes after what I've always considered my aura, a moment of extreme dizziness, confusion, and the feeling as if I've been smacked upside the head (as if the room itself turns on edge).
It's actually a bodily feeling, not visual at all, just as if someone came up from behind and whacked the side of my head. I have actually stumbled when this happens because I get an almost 'faint' feeling when it happens, combined with a feeling of force of some sort.
After this I know... nonalcoholic drunkenness, then pain. I can usually stop the pain from happening if I take some drugs right after the initial onset."

(jagnightwalker, LiveJournal for Support Group for Migraine Sufferers, Subject: Between Aura and Pain, August 26-27, 2005)

Sensations of experiencing an earthquake

"I have experienced a similar symptom, where the 'zap' comes on, kind of like a pulse of electrical shock. It doesn't hurt, but it is very disorienting. About a year ago I had one single episode, and for that split second I thought we were having an earthquake. Last October I had another session, started the day after a particularly bad migraine. The first day was really bad, and they lasted three days, slowly tapering off. I had mega tests done, including an MRI, and everything came back normal. I live with the dread that they may return."

(Trixie, Newsgroups: alt.support.headaches.migraine, Subject: Vertigo?, August 12, 2005)

Caro W. Lippman (1951) described two similar cases of space-motion hallucinations occurring in migraineurs under the heading "The earthquake".

Sensations of jerking, thrusting back, or rocking

"Several years ago I began taking Effexor Xr for depression/anxiety as well as vertigo that my neuro attributed to be connected to migraine. After having severe and almost constant vertigo and going to many different doctors and trying many different things this drug finally helped. ... I get a few different feelings. One is a more severe vertigo that was chronic until I began taking Effexor. I was tested by all sorts of methods and saw all kinds of doctors and it was finally concluded that the vertigo was related to migraine and is influenced by the same things that effect migraine (like stress, sugar, heat, exhaustion, etc) but occurs when I am not having an actual migraine. The vertigo feeling I experience is like a feeling that the flow is rising up or falling down or moving a bit or my head is jerking or thrusting back a bit when it is not. Sometimes I also get a feeling like I am rocking. The vertigo sometimes comes with a feeling of general unbalance. Since beginning the Effexor I only have the vertigo every once in a while, especially when I bend my head down at the sink in a well lit bathroom, or step out of an elevator. I have recently had a return of the vertigo with my reduction in Effexor, but have also heard this is a side effect of withdrawal of Effexor."

(wallacebizbot, LiveJournal for Support Group for Migraine Sufferers, Subject: Auras sans migraine, December 13, 2005)

Sensations of moving through space

"I get migraine aura that can be dissociated from headaches... I tend to get vestibular illusions too, and feel like I'm travelling though space... It could be described like that (astral travel), but whenever I experience it I am always aware that it is an illusory sensation and that my body is not actually moving through space."

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

Sensations of moving through tunnel

The so-called tunnel experience as part of a so-called near-death experience may involve, besides a visual hallucination of tunnel form dimension, a disturbance of the body image affecting its position in space with a feeling of moving through a dark tunnel towards a light, as suggested by the "tunnel moving" feeling recorded in the following account of a migraine sufferer's recurring migraine aura symptoms featuring near-death experiences:

"I get migraines. When the medicine they give me doesn't work I sometime get the near-death- experience. It doesn't change my life because it happens not a lot, but too often to be unusual, it's just part of a bad migraine. I'm surrounded by a darkness that is bright at the same time and all is peaceful, and it appears to be a tunnel sometimes it moves around me (which sometime is a little scary) sometimes I'm just looking at it. I don't have any other thoughts that I'm aware of just the peacefulness. (unless the tunnel moving feels scary)" [more]

(Lisa Smith, Omidyar Network, Groups – Religion – Discussion, Subject: Does God exist?, April 24, 2005)

Sensations of sailing

"Dizziness - Mr. migraine man hit me with his baseball bat and now I am sailing. Anyone has any good advice about dizziness… any herbs or so that can stop me from feeling that I am sailing? And is this normal btw?... I know nausea is very normal, but I don't see a whole lot of people complaining about dizziness. ... I am dizzy even when I am lying down... it feels like my bed is sailing with me… or my whole house even... big waves today."

(the northbound, LiveJournal for Support Group for Migraine Sufferers, Subject: dizziness, August 19, 2005)

References

Lippman CW. Hallucinations in migraine. Am J Psychiatry 1951; 107: 856-858.
Lukianowicz N. "Body image" disturbances in psychiatric disorders. Brit J Psychiat 1967; 113: 31-47.

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