Neurology 1973;23:570-579This report concerns the visual phenomena 100 children experienced during attacks of migraine, emphasizes how common these phenomena are, and considers the physiologic and anatomic mechanisms producing visual impairment, scotomas, distortions and hallucinations. Migrainous visual symptoms, familiar to many physicians from personal experience, often herald or accompany head pain and often indicate the severity of the attack that is to follow. Migraine and its visual accompaniments are as common in childhood as in adulthood. Visual symptoms tend to be unique, distinct and stereotyped for the individual. A clear description of them is of value, for when associated with other systemic and neurologic accompaniments they permit a firmer diagnosis of migraine, reducing the need for detailed neuroradiographic study.Free Access to this article at www.neurology.org/content/23/6/570 Comment from Vladimir Hachinski, MD, DSc: Visual symptoms in migraine was the topic of my first paper in Neurology, an interest arising from my own fascinating visual auras. I interviewed and examined 100 children who then saw a medical artist, who asked, encouraged, or cajoled as necessary, all of the children to draw what they experienced. The first presentation to the American Academy of Neurology was under the supervision of Dr. John Steele, then at the Hospital for Sick Children in Toronto. The children's striking pictures were a hit (figure), even attracting attention from CBS News.Encouraged, I began writing up the manuscript. It proved much more difficult than letting the children's pictures speak for themselves. So I sent the manuscript to Neurology with 36 illustrations, many in color. I got a polite letter back from Dr. Russell DeJong, Founding Editor of Neurology, saying that the number of illustrations was excessive and the cost of the color illustrations would be several hundreds of dollars! I gasped-that amount was a good chunk of my first-year resident's salary, meager at the time, particularly for a married man with an infant son. Regretting that I could not afford the illustrations, I revised the manuscript with 9 illustrations, 4 in color, fully expecting the illustrations printed in black and white and having the number reduced.To my surprise and delight, Dr. DeJong accepted the paper and all the illustrations, without charging me for the illustrations! I was overjoyed and soon saw my first paper published.Only years later, while editing the journal Stroke, did I come to appreciate fully the extent of Dr. DeJong's generosity. His gesture made me a more understanding, supportive, and kind Editor than I may have otherwise been.When Dr. DeJong died, I gave a brief account of his generosity, 1 in response to which I received several communications documenting similar acts of kindness. 1. Hachinski V. Russell DeJong. Ann Neurol 1991;30:116. Metamorphopsia in case 8. Other children (right) appeared unusually small to the patient (left).
