Setyembre 7, 2026

Isolated Transient Alexia — a migrainous accompaniment — ever had it?

JAMA Neurology abstract: "Alexia as a transient or paroxysmal neurologic event is a rare clinical finding. John Hughlings Jackson made reference to the paroxysmal occurrence of 'word blindness' as a temporary sequela of neuronal exhaustion at an epileptogenic focus.... A transient episode of alexia in the absence of accompanying neurologic deficit is exceedingly rare.... We recently observed a patient who experienced an isolated, transient alexia that appears to have been a migrainous accompaniment...."

I suspect this happened to me. Here's what I was trying to read and could not make any sense of it, and I struggled from all different angles: "The Story of the Foul-Mouthed Parrot Andrew Jackson Once Had" (an episode of a podcast I like: "Boring History for Sleep"). 

Now, I think that's a type of headline that is objectively hard to puzzle out. I encountered another one this morning in the NY Post: "Missouri foster mom accused of trading teen for monkey avoids prison." Something about the sequence "monkey avoids prison" sends your thoughts tripping over the precipice. 

But that "Foul-Mouth Parrot" headline was entirely undecipherable to me. I searched for an entry point: What is "Story"? What is "Andrew"? "Foul"? I couldn't even think of how to begin to pronounce those words or how words work together to mean something. This not-knowing lasted for about 15 minutes, and of course, I queried A.I. about it. That was after Meade had consulted a different A.I.

And I believe all A.I.s will tell you the same thing if you put this story into it — not the story of Andrew Jackson's parrot or the story of the foster mom's monkey — the story of a reading human suddenly completely unable to read. And we did what A.I. told us to do. That's why there was no sunrise photo yesterday. Our sleep was massively disrupted. I had to get my head examined.

ADDED: I omitted a crucial detail that is why I was thinking in terms of a migrainous accompaniment. About an hour before the alexia, I experienced a scintillating scotoma — a glittering arc'd zigzag in my visual field. I've had that twice before, in 2004 and 2014. In 2014, I treated it as nothing, but it felt like a big deal in 2004. I blogged it as "My scotoma" (deliberately evoking "My Sharona"):
This afternoon, I was reading something on the computer screen, when I realized I could not see a spot about the size of one letter in the center of the screen. Instead of the letter I was trying to read I saw a spot of roiling light. I stopped reading and looked around and the roiling light spot was getting larger and opening up into an arc, a backwards c, that glittered and took on a zigzag shape and moved gradually off to the right. It looked the same if I closed one eye or another, signifying that nothing was wrong with an eye, but that my brain had to be the problem. I did not, however become alarmed. I had read Oliver Sacks's book "Migraine" and knew about the pre-migraine visual disturbance called "scotoma." I googled "scotoma," went to the second item Google retrieved, and found... an animation of "a classic migrainous scintillating scotoma from a small paracentral bright spot to an enlarging bright, curved, zig-zag line (the scintillation)." The animation was precisely what I saw — save that mine exited stage right instead of stage left. The website predicted it would last 10 to 20 minutes, and in fact that was exactly so: the arc slipped out through my peripheral vision.

That was, for me, the all-time best performance by the internet. But yes, I did still call the doctor, mostly because it happened again a half hour later. I got sent to the emergency room, where I told the story of my scotoma to five different people, with the final verdict coming from the neurologist who said, given that I never did get a migraine headache out of all of this, that it was a "migraine equivalent."

Scintillating!

So I associated the scotoma with a migraine, and then I googled about my incapacity to read and found a JAMA article that not only gave me a name for it — alexia — but connected it to migraine. So I had 2 things, within an hour that were associated with migraine. 3 really, because I did have something of a headache surrounding my left eye. 

60 komento:

Aggie ayon kay ...

Geez, that must have been terrifying. Hope everything has worked out to your satisfaction, and it was nothing more than a solid brain fart, which happens to all of us from time to time.

n.n ayon kay ...

Is there another Althouse Intelligence in Meade's life? Oh, Ann. Of course.

Reddington ayon kay ...

Hope all is well in the Althouse Meade House

FullMoon ayon kay ...

Kinda reminds me of:

"See, whatever happens can be said to have happened for the reason you've already reasoned is the reason for whatever happens to have happened. "

Magilla Gorilla ayon kay ...

Hope everything is okay. We depend on you.

rcommal ayon kay ...

Althouse: I wonder, would that headline have been so confounding if there had been a "that" between "Parrot" and "Andrew"?

Not infrequently, headlines or sentences like that make my mind go in all directions. Often enough, adding a "that" or some such solves the problem, for me.

john mosby ayon kay ...

I know everything will turn out ok. CC, JSM

baghdadbob ayon kay ...

JAMA Neurology abstract: "Alexia as a transient or paroxysmal neurologic event is a rare clinical finding. John Hughlings Jackson made reference to the paroxysmal occurrence of 'word blindness' as a temporary sequela of neuronal exhaustion at an epileptogenic focus....

It happened to me once, a couple of decades ago at work. I thought I was having a stroke as the words and letters were jumbled on the page. It was terrifying! Hasn't happened again, knock on words.

I'm going to ask Alexa about Alexia now, and bask in the confusion.

rcommal ayon kay ...

I wonder if some significant time, decades ago, spent writing headlines helps me do the deciphering. I dunno.

Narr ayon kay ...

Did you try diagraming?

William50 ayon kay ...

Interesting that it would effect reading but not typing. Can you understand what you typed when you go back and read it?

RideSpaceMountain ayon kay ...

"Isolated Transient Alexia — a migrainous accompaniment"

New masthead?

Not an oldster. ayon kay ...

Take a break?
Stop consuming, and displaying, info online?
Is your head tr y ing to tell you to stupid querying and check in with the natural world? Put down the camera and the comments listen to your body and live?

Meade has an interest in keeping you working, no? He is kinda using y0u so try to put your own needs first... stroke?

Marcus Bressler ayon kay ...

Wish you well

Smilin' Jack ayon kay ...

Seems analogous to what linguists call a garden-path sentence.
Examples:

"The old man the boat."
“Time flies like an arrow; fruit flies like a banana.”
“The horse raced past the barn fell."
"The complex houses married and single soldiers and their families."

They’re fun, and don’t indicate brain damage. (But no guarantees.)

Rosalyn C. ayon kay ...

Sounds very scary. Sounds like your highly trained super intelligent mind was thrown off balance by poorly composed mediocre sentences.
I don’t know if it’s a similar experience, but sometimes I get thrown off track by the non binary use of “they/them” pronouns in extended sentences. I have to remind myself I’m dealing with idiocy and step back from my expectations of rationality.

rcommal ayon kay ...

Relative pronouns have fallen almost completely out of favor over the past couple of decades. (This is not the only change that has promoted less clarity, IMHO.) I frequently enough trip over headlines and sentences for that reason.

Bring them back, please!

bagoh20 ayon kay ...

You may have found it already, but there are YouTube videos like the one below that are hours of etymology to put you to sleep, but I found it so interesting that it kept me awake.

"A Solid 3.5 Hours of Useless Information to Fall Asleep To"
https://www.youtube.com/watch?v=tiKXQaV6rJw&t=8892s

Ann Althouse ayon kay ...

"Althouse: I wonder, would that headline have been so confounding if there had been a "that" between "Parrot" and "Andrew"?"

I know: Is the parrot's name Andrew? That's the objectively confusing part. And the "had" stranded at the end. And what's the point of "once"? I later learned that Jackson kept that parrot for over half a century, and its dirty-mouth outburst came after Jackson had died, and the parrot was stressed by the unusual crowd that had accumulated at The Hermitage.

But I couldn't even understand the proximity of "Andrew" to "parrot." I think I could not even understand that Andrew was a name or that parrot was an animal.

RCOCEAN II ayon kay ...

Never happened to me - but it sounds scary. Hope its just a temporary thing.

rcommal ayon kay ...

My brain can be contrarian. I tried the "Boring..." podcast to which Althouse alluded, but it kept me awake! I just go down rabbit holes and feel compelled to look up things. So I guess it's just another "no one size fits all," with the extension of "and if it does, not all of the time."

Althouse, I really do hope this isn't a harbinger and that it's resolved. I can see how disturbing the experience must have been.

RCOCEAN II ayon kay ...

The story of andrew johnson's foul-mouthed parrot. Seems like a clearer and more concise healine.

Mom trades teen for monkey - avoids prison. Also a better way to write it.

Ann Althouse ayon kay ...

"Geez, that must have been terrifying."

Oddly enough, I wasn't anxious at all. I couldn't believe I had to go to the emergency room, but when AIs concurred, I accepted it. Everything got treated like a very high priority, so I understood what that meant, but I still felt that nothing was really wrong and I hoped to get out of there and back home. You might as well worry all the time. Anyone could have a stroke at any moment. What are you going to do, spend your life in fear? Just do what you've got to do when there are precautions to take and don't indulge in anticipatory suffering. If you can't help it, you can't help it, but you're lucky if you don't.

Bob Boyd ayon kay ...

Alternate headline:

Extremely well-trained head examined on wild, untamed continent.

rcommal ayon kay ...

You're a better woman than I, Althouse. I do worry about stuff like that, especially because I'll be living alone.

Congrats on your calm! I'm sure it's much the better way.

P.S. Small OT, I happened to mistype "Althouse" in this comment (left out the "l") and autocorrect fixed it for me! I'm sort of dumbfounded. Are you that famous, or have I just typed that "word," in this context so very many times, including in url lines, over the years?

See what I mean? Another rabbit hole for me.

loudogblog ayon kay ...

I have noticed, as I have gotten older, that this type of situation happens to me more often. I'll try to read something and I'll have to back away for a minute to come back and take a second stab at it.

Another thing too, is that writing/language has changed from when I was in college. People express themselves differently, which makes it harder to understand what is being communicated sometimes. (And thus requires multiple readings of a sentence to finally suss it out.) This obviously works both ways, based on the number of times that people have said, "OK, boomer." to me.

rcommal ayon kay ...

An eon ago, I used to use pencil to correct sentences for more clarity in books I read, and sometimes would even rewrite the sentences in the margins. This was way before I spent time as an editor. Maybe it's hardwired to be bugged like this, at least at some point. I hope it doesn't get worse.

john mosby ayon kay ...

Good thing you hadn’t run across Buffalo buffalo Buffalo buffalo buffalo buffalo Buffalo buffalo. CC, JSM

Smilin' Jack ayon kay ...

The Buffalo sentence should be in all caps, otherwise it’s too easy to see what’s going on.

Fred Drinkwater ayon kay ...

My advice for communicating in a multilingual work environment: "Don't write to be understood. Write so that you cannot be misunderstood."

Clyde ayon kay ...

Wouldn't it be a foul-beaked parrot?

Ann Althouse ayon kay ...

"Sounds very scary. Sounds like your highly trained super intelligent mind was thrown off balance by poorly composed mediocre sentences...."

Yes, I am interested in the idea that a sentence could be so badly written that it would annihilate mental functioning... like that mythic joke that causes laughter unto death.

narciso ayon kay ...

It seems an absurd sentence

Ann Althouse ayon kay ...

"Wouldn't it be a foul-beaked parrot?"

I think "beak" corresponds to "lips." We've all got a mouth — human and bird.

forest ayon kay ...

Possibly prodromal symptoms which can precede a migraine? One can have the symptoms even if the pain does not follow.

Eva Marie ayon kay ...

I’m glad you got checked out and that you’re okay. Take care.

Bob Boyd ayon kay ...

I don't really need to be able to read every sentence that comes along, do I? I figure there's plenty more where that one came from. If it was important, I'll find what it said sooner or later.

Rabel ayon kay ...

Good luck. I hope it's the Zebra you're diagnosing and not a more likely possibility.

Rabel ayon kay ...

If it was the former then I would blame the line break after "Andrew" rather than the sentence itself.

Once you connect "Andrew" with "Jackson" it makes sense.

Inga ayon kay ...

I imagine follow-up with a neurologist or a related specialist was recommended at the ER.

Lee Moore ayon kay ...

The parrot and the monkey caused my synapses no difficulty at all. But the first para about Alexia was gibberish. Because it was composed of polysyllabic jargonese.

rp ayon kay ...

Ann, I make this comment only to suggest something you might want to investigate. Many migraines -- and many so-called "migraine equivalents" -- are helped to calm down and/ or to go away by taking B2/ riboflavin. While this approach had been hinted about in the 1940s, it led to a lot more medical research since the 1990s, as it became clear that many varieties of "migraine equivalents" were being seen more frequently in children -- and the then existing migraine prescriptions seemed possibly dangerous to be using in children. I believe that the articles still are arguing as to whether this approach is treating a mitochondrial issue or a neurologic issue -- or both. My sense is that pediatric neurologists have used this approach for safely treating a miscellany of phenomena. The dosing in adults "seems" quite large -- but is it common: 400mg by mouth after supper and maybe another such dose at bedtime; I mention that here only so you will not be startled if your medical physician mentions that large numeral.

Narr ayon kay ...

I read Alexia as Alexa and didn't catch on that you had to go the ER until you 'splained it.

Glad you checked out OK.

Last fall my wife spit up a lot of blood and fell over in the kitchen late one Saturday night--early Sunday morning actually--when I was already abed and asleep. I got up eventually and noticed she was still up but lying in a sweat on the living room sofa.

I cleaned up the mess in the kitchen and asked if she wanted to go to the hospital bit she felt better and had a doctor's appointment the next afternoon anyway so we decided to wait.

The next afternoon her doctor reproached us and sent her to the ER. After seven hours of waiting, they got her a room and said she had a bleeding esophageal ulcer which they cauterized the next day. She was out by Thursday.

When people ask why I didn't take her to the ER immediately I just point out that they have never tried to get my wife to do something she didn't want to do.

Asking the internet never occurred to me and probably wouldn't have made a difference anyway.

RCOCEAN II ayon kay ...

Let me stand up for parrots. The birds - not their human counterparts.

Polly just wants a cracker and will imitate any sound they get rewarded for making. The reward can be attention or food.

Original Mike ayon kay ...

I have been having an increasing occurrence of scintillating scotomas. My ophthalmologist called it an "ocular migraine" and didn't seem concerned about it. Mine last about a half an hour. As long as they continue to go away…

Used to have them every few years. Now I've had three since the beginning of the year.

Meade ayon kay ...

Hoping to be in contact with neurologist by end of business day tomorrow. Everything seems stable and normal today. Grateful for excellent care from all at the UW hospital/ER and for the well wishes by everyone here, both said and unsaid.

Fred Drinkwater ayon kay ...

Months ago I had a persistent scotoma-like phenomenon, without the glittering arc. Just the roiling spot. Hmm. Actually, its still there, but quite faint now. I've never had a migraine.

Its more apparent in my right eye, where I also have some dry macular degeneration.

Biff ayon kay ...

Best wishes that all is well.

On a selfish note, THANK YOU for this:

"I experienced a scintillating scotoma — a glittering arc'd zigzag in my visual field."

I've had perhaps five or six temporary encounters with them in the past ten or so years, and I never quite found the word for them. A "glittering arc'd zigzag in my visual field" is exactly what I've experienced.

I mentioned them to my physician and to a friend who is an ophthalmologist, and both did a few quick tests and said not to worry unless I noticed an increase in the frequency or duration of the phenomenon. The scotomas did seem to be associated with periods of unusual stress or exhaustion and, now that I think of it, secondary migraine symptoms. (I haven't been prone to have "standard" migraines.)

I used to teach neuroanatomy years ago. I'm truly fascinated by how the "scintillating scotoma" works and am trying to imagine how the brain's circuitry can come up with such a vivid, angular phenomenon.

Biff ayon kay ...

PS. My thanks to the Professor are due to having a name to associate with the phenomenon. I don't recall either physician using "scotoma" in our visits.

EAB ayon kay ...

Hmmm. That would be scary. I’ve gotten scintillating scotomas off and on for a number of years. (Thanks for the name, by the way. I always thought of them as ocular migraines.). I get no headache. They start as a tiny shiny/sparkling circle that grows and breaks into a C that moves out of the frame, just as you described. Last about 20 minutes. No idea what triggers them.

Biff ayon kay ...

I did some digging, and it turns out that there is a generally accepted anatomical/mechanistic explanation for how these discretely angular scotoma appear.

Some of you may recall the concept of "optical dominance columns" from college biology to describe how the brain's visual cortex is spatially organized, generally corresponding to particular points in our visual fields. (Coincidentally, I was acquainted with one of the people who won a Nobel for that discovery back in the early eighties.)

The basic idea with these particular types of scotoma is that they originate from unusual, aberrant signaling in the visual cortex that subsequently spreads across the boundaries of adjacent cortical columns as the scotoma develops. The specifics are pretty complicated, but they explain the orderly, albeit erroneous, pattern of neuronal activity that creates the distinct, localized visual artifacts in our visual field. Eventually, the neurons return to normal, and the pattern resolves itself.

Mike (MJB Wolf) ayon kay ...

When younger I occasionally suffered migraines, often accompanied by sparkly visual effects. The brain pain alone kept me from reading but never produced the inability to decode sentences. I find that interesting.

Unrelated to my migraine experiences (which resolved about 1989 and never returned with the impact of those I had in my 20s) but similar to Althouse’s ITA experience was an episode sitting in church before the service and the word “worship” on the Songs for Worship hymnal suddenly became unintelligible. I sounded it out quietly. It didn’t sound like a word I recognized except the homonym “warship” and that thought almost made me LOL. The word just seemed wrong. Within about ten minutes it resolved. The word did not seem wrong or unintelligible any longer. But I remember that feeling every time I see the word. Even now roughly 25 years later.

michaele ayon kay ...

Several years ago, I experienced my first optical "migraine" and I get them now and then. I remember describing it to the ophthalmologist as the way words of dramatic action are drawn in a Batman comic book. Zap, Bam, Zow with crazy wiggly line shapes in bright colors around the words. I don't see the words...just the outlined shaped. The doctor is the one who gave me the phrasing of optical migraine. There is no pain and they go away after a half hour or so.

Ann Althouse ayon kay ...

Thanks for the science, Biff!

Optical dominance columns... I'll remember that.

Tacitus ayon kay ...

Getting the aura but not the subsequent headache is what I used to liken to "playing the National Anthem and then not having a baseball game". In the Olde Days these were called Fortification Scotomata as they produced lines reminiscent of the irregular tops of castle walls. These walls overall were referred to as "crenellations". Your hopefully now legible word for the day.

Peachy+2 ayon kay ...

I've had that distressing optical flashy zig zag.
I was told it was an Ocular migraine.

Original Mike ayon kay ...

I don't get a sense of zig-zags. It's more like the optical scene is broken up into small puzzle pieces which are then moved around into the wrong places. I certainly do get the scintillating experience.

Narr ayon kay ...

@Original Mike9:58--

I get those too.

Barbara ayon kay ...

A certain type of badly written headline is called a crash blossom. The example given in the Merriam-Webster entry is "Whale watching boat carrying 27 sinks".

The name "crash blossom" comes from a Japan Today headline "Violinist Linked to JAL Crash Blossoms".

Brian McKim and/or Traci Skene ayon kay ...

I thought the phrase was ocular migraine. I no longer panic. They're harmless.

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