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Título

CHARCOT AND MIGRAINES: A PERSONAL RELATIONSHIP

Resumo

Introduction: Professor Jean-Martin Charcot is widely recognized as one of the most influential physicians of the 19th century. As head of the Neurology service of the Salpêtrière, Charcot developed a reputation as both a clinician and a professor. In his Leçons du Mardi, Charcot presented patient-guided discussions on neurological diseases, presenting the audience with his appraisal of the medical literature and his practical experiences on the subject. Although few of these discussions approached headache disorders, as a migraine sufferer Charcot was able to present his insights uniquely. Objectives: This work discusses Charcot’s lecture on migraine and his personal experiences on the subject. Methods: We present historical evidence concerning Charcot’s lecture on migraine, originally presented on November 22, 1887, including excerpts and original drawings representing his visual auras. Results: Charcot presented the case of a 37-year-old teacher who presented a 12-year-history of “seizures” accompanied by limb paresthesias and speech impairment. Although the patient reported that she never lost consciousness, she presented visual phenomenology that included scotoma and line of fortification, sometimes followed by severe headaches. Charcot exposed his own experiences as a migraine sufferer, describing the visual auras: “I know the shape of this picture for myself from having felt it, but the description comes from an astronomer […] Sometimes the scotoma presents only the line of fortification of yellow tints, sometimes red and green tones, and inside the luminous zone, which remained dark, you can see a kind of smoke, vapor more or less thick, vibrating in a way reminiscent of what is seen in the atmosphere immediately above a working stove. The initial very narrow circle gradually widens and finally ends up disappearing, a new phenomenon succeeds it, hemiopia, which is to say that by looking someone in the face, we do not see distinctly half of his figure. From this moment, pain is felt in the affected eye and above. Gradually the ocular phenomena disappear but the pain persists, and vomiting may occur.” Conclusion: As a professor and a migraine sufferer, Charcot offered a unique perspective on migraine phenomenology. Although none of these descriptions were new at the time, the richness of detail provided by Charcot certainly paints a picture of the experiences our migraine patients go through.

Palavras Chave

History of Neurology, Jean- Martin Charcot, Headache, Migraine