A basilar migraine, also known as a basilar artery migraine, is a type of migraine that begins in the brainstem. Symptoms may include aura, vertigo, speaking and hearing difficulty, and loss of muscle control.
Researchers are not sure what causes basilar migraine. Various treatments can help prevent these episodes and lessen their intensity.
Among migraine types, basilar migraine is rare. Because it begins in the brain stem, a doctor may call it “migraine with brain stem aura.”
This aura may involve changes in a person’s speech, hearing, or vision — they may see lines, flashes of light, or spots in their field of vision. Also, a person may experience pain before or during these changes, and the pain may occur on one or both sides of the head.
A person will typically feel exhausted or drained following a basilar migraine episode.
The aura of a basilar migraine episode can resemble the auras of other types of migraine. A person may:
- have vision changes
- see static or zigzagging lights
- see spots or stars
- have sensitivity to light or noise
- have numbness in the face, head, and hands
Other symptoms are specific to basilar migraine. They
- difficulty speaking
- impaired hearing
- double vision
- impaired muscle control
- a reduced level of consciousness
- tingling on both sides of the body
Aura symptoms usually occur before the onset of pain, which can range from moderate to severe. The pain may begin in one area of the head before spreading.
Migraine can also cause allodynia. A person with allodynia feels pain from light touch, such as from clothing brushing against the skin.
Overall, it is important to note that the experience of migraine varies from person to person and episode to episode.
The sensory changes that occur with basilar migraine pass. But having this type of migraine can increase the chances of experiencing other health issues, such as ischemic stroke.
The medical community still does not fully understand the connection between migraine with aura and stroke risk.
Females who experience migraine with aura and who take combined contraceptive pills may have a particularly high risk of ischemic stroke. For this reason, the World Health Organization (WHO)
Smoking, too, can increase the risk of experiencing stroke. A person with basilar migraine may wish to avoid smoke or quit smoking for this reason.
Experts do not know what causes basilar migraine, also known as migraine with brain stem aura. However, several external factors can trigger these episodes.
Triggering factors include:
- nitrites in food
- prolonged hunger
- bright lights
- motion sickness
- lack of sleep
- strong smells, including some perfumes
- rapid changes in barometric pressure or weather
- having overweight
- overuse of headache medications
- hormonal contraceptive pills
- hormone fluctuations, in females
- blood pressure medications
- epilepsy or seizures
Usually, a doctor diagnoses basilar migraine once a person has reported having at least two episodes that meet
Basilar migraine can resemble hemiplegic migraine, but the latter tends to cause weakness on one side of the body.
Other, more serious medical conditions that have similar symptoms to basilar migraine include:
To rule out these conditions, a doctor or neurologist may request an MRI or CT scan.
Treatment for basilar migraine tends to focus on reducing pain and managing the other symptoms.
A doctor may recommend:
- nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen
- antiemetic medications, which combat vomiting and nausea
If over-the-counter medications do not help, a doctor may prescribe a stronger alternative. In some cases, they may recommend a type of drug called a nerve block to reduce the pain.
People who experience basilar migraine episodes should take precautions as soon as they recognize the warning signs. Aura symptoms tend to develop before the pain.
Some pain relief and anti-inflammatory medications tend to be more effective if a person takes them before the pain becomes severe.
A doctor may prescribe preventive interventions, such as:
- Botox injections
- seizure-reducing medications, such as topiramate (Topamax)
- verapamil (Isoptin), which can lower blood pressure
Certain lifestyle changes may also help reduce the occurance of migraine episodes. A person might benefit from:
- avoiding dietary triggers, such as alcohol and caffeine
- exercising regularly
- finding ways to reduce stress
- eating a balanced diet
- getting regular sleep
- not skipping meals
- reducing exposure to noise
A person with migraine could also benefit from:
- relaxation techniques, such as yoga
- cognitive behavior therapy
- biofeedback therapy
If a person begins to notice symptoms, such as those of an aura, it may help to stop any activity immediately and rest in a quiet, dark area.
In this situation, a person could also benefit from taking pain medication, even if the pain has not yet started.
Basilar migraine can be more severe and longer-lasting than other types of migraine.
With age, however, the episodes tend to become less frequent and their pattern becomes more predictable, according to
Making lifestyle changes, such as avoiding known triggers, may help reduce the frequency of episodes. A doctor can also recommend or prescribe a range of treatments.
Anyone who experiences aura symptoms should see a doctor, who can rule out more serious conditions. It is also crucial to seek medical care if loss of consciousness occurs during a migraine episode.