Researchers are not sure what causes basilar migraines, but treatments are available to prevent them and lessen their intensity.
What are basilar migraines?
A basilar migraine affects the vision, causing an 'aura' of flashing lights, spots, or lines.
A basilar migraine is a rare type of migraine that begins in the brain stem. A basilar migraine may be caused by a constriction of blood vessels that limit blood flow to the brain.
Other conditions that restrict blood flow, such as tortuous blood vessels, may also cause basilar migraines.
Basilar migraines can affect a person's senses, particularly their sight. This is referred to as a migraine with aura. A basilar migraine may cause a person to see lines, flashes of light, or spots. The pain of the migraine may occur before or during these other symptoms.
Basilar migraines may affect one or both sides of the head. Aura symptoms can last for about an hour before fading, but the migraine itself may last between 4 hours and several days. A person will typically feel exhausted or drained following a basilar migraine.
Basilar migraines have a variety of specific symptoms, but also share symptoms with other aura migraines.
Symptoms specific to a basilar migraine include:
- slurred speech
- loss of muscle control
- cold hands or feet
- blacking out or fainting
- ringing in the ears
- extreme dizziness
- a sense that the room is spinning, making it difficult to stand
- temporary blindness
- double vision
- nausea or vomiting
Symptoms shared with other aura migraines include:
- vision changes
- seeing static or zigzagging lights
- seeing spots or stars
- sensitivity to light or noise
- numbness in face, head, and hands
- seeing lights not coming from an explainable source
Aura symptoms usually occur before the onset of the migraine pain, which can range from moderate to severe. The pain may concentrate in one area of the head before spreading.
Migraines can also cause allodynia, which is when a light touch, such as clothing brushing against the skin, causes pain.
Symptoms will vary between people and between instances.
People who experience basilar migraines may also be at higher risk of ischemic stroke. The connection between migraines with aura and stroke risk is not fully understood, but an ischemic stroke is caused by a reduction in blood and oxygen supply to the brain.
Women who take combined contraceptive pills and experience migraines with aura are at an increased risk of ischemic stroke. For this reason, the World Health Organization do not recommend prescribing combined pills to women who experience this type of migraine.
Some researchers believe that a basilar migraine occurs when the basilar artery gets constricted, but more research is needed to confirm this. The basilar artery runs from the back of the neck into the brain stem and is responsible for bringing blood to the brain.
There are, however, several external factors known to trigger basilar migraines. These include:
Basilar migraines may be caused by a constriction of the basilar artery, which brings blood to the brain.
- bright lights
- motion sickness
- hormonal contraceptive pills
- blood pressure medications
- prolonged hunger
- lack of sleep
- strong smells, including some perfumes
- hormone fluctuations in women
- epilepsy or seizures
- rapid changes in barometric pressure or weather
- nitrites in food
- being overweight
- overuse of headache medications
A doctor will likely diagnose a basilar migraine once a person has experienced at least two episodes of aura symptoms. Basilar migraines are sometimes similar to hemiplegic migraines, but hemiplegic migraines tend to cause weakness on one side of the body.
Other, more serious medical conditions that have similar symptoms to a basilar migraine include:
To rule these conditions out, a doctor or neurologist may recommend a magnetic resonance imaging scan (MRI) or a computerized tomography (CT) scan.
Various medications may be recommended for treating basilar migraines, including NSAIDs.
Treatment for basilar migraines tends to focus on reducing pain and treating the other symptoms of the migraine.
Medications a doctor may recommend, include:
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
- antinausea medications
- triptans, which regulate serotonin levels
If over-the-counter medications are not having any effect, a doctor may prescribe a higher dosage. In some cases, a nerve block may be used to reduce pain.
People who experience basilar migraines should also be aware of aura symptoms, which can act as a warning for an oncoming headache. Some painkillers and anti-inflammatory medications may be more effective if taken before the pain becomes unmanageable.
Preventing basilar migraines
A doctor may prescribe preventative medications to reduce the risk of getting a migraine. These medications include:
A person may also be able to reduce their risk of basilar migraines by making some lifestyle changes. Changes a person may consider include:
- avoiding trigger foods, such as alcohol or caffeine
- exercising regularly
- taking breaks and relaxing to help relieve stress
- eating a balanced diet
- getting regular sleep
- not skipping meals
If a person begins feeling aura or migraine symptoms, they should stop activities immediately and go to a quiet, dark area. They may also wish to take pain medications as a preventative measure, even if the pain has not yet started.
People can often manage basilar migraines with positive lifestyle changes, such as eating well, doing exercise, and taking over-the-counter medications to relieve symptoms as soon as they appear. Avoiding known triggers can also help reduce the risk having a basilar migraine.
In situations where a person cannot manage the pain at home, they should speak to a doctor about treatment options.
Anyone who loses consciousness during a migraine or experiences aura symptoms should see a doctor who can rule out more serious conditions.