PATTERNS OF CEREBRAL INTEGRATION INDICATED BY THE SCOTOMAS OF MIGRAINE

The scotomas characteristic of ophthalmic migraine have been described by a number of investigators.¹The visual disturbance precedes or accompanies other symptoms of migraine and is usually of short duration. It is generally restricted to one half of the visual field, the right or the left, and ranges in size from a scarcely noticeable blind-spot to total hemianopia. A great variety of forms have been mentioned in the literature, but those which have been described in detail are of much the same type. The scotoma starts as a disturbance of vision limited to the neighborhood of the macula and spreads rapidly toward the temporal field. With increase in size the disturbed area moves or "drifts" across the visual field, so that its central margin withdraws from the macular region as its peripheral margin invades the temporal. Spread from the temporal toward the macular region has also been described and