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Gutheil, E. (1934). Analysis of a Case of Migraine. Psychoanal. Rev., 21(3):272-299.

(1934). Psychoanalytic Review, 21(3):272-299

Analysis of a Case of Migraine

E. Gutheil

I. Status Praesens

The patient, Mrs. Eva P., aged thirty-two, is married, childless, and has been suffering from migraine since the age of sixteen. The attacks are typical, and come on, on an average, every two or three days, usually lasting a few hours; at times, from two to four days, being interrupted only during the sleeping hours. For the most part, the attacks begin with optic scintillation (migraine ophthalmique) which is followed by nausea and a tendency to vomit. During the attack the patient is very sensitive to pressure on the head. Sensitiveness to sound, light, and certain odors, which is characteristic of this sickness, is also present.

The outstanding symptom of this case of migraine is the fact that the attack in most cases ends after a manifest sexual orgasm. The headache lasts until a spontaneous sexual relaxation takes place. Sometimes the patient gets several orgasms before relaxation and, with it, the end of the attack comes. Many attacks are closely related to menstruation.

The physical examination showed nothing of importance etio-logically. No heredity. Frigidity and a heart neurosis are the only neurotic symptoms worth mentioning.

II. Case History

1. Childhood. Experience with Her Father

Mrs. Eva P. comes from a middle-class family. An only child. Father and mother are alive and healthy. The patient's earliest recollections go back to the age of three. She remembers having been in a row-boat with her father at the time of a flood, the latter rowing vigorously. As a child she was very wild and frolicsome. Once (age four/five) she tried to enter her father's office, with her eyes closed, fell down, and lost consciousness for a time.

Eva was about six when her father got into bad company. He came home drunk quite often, and the disagreeable scenes between him and her mother left their marks on the tender mind of the child.

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