Basilar Migraines: What They Are And What You Need To Know

While most people have heard of migraine headaches, many people don't know that there are several types of migraine, each with different symptoms, causes, and treatment recommendations. Basilar migraine, or migraine with brainstem aura (MBA), can cause debilitating symptoms. If you suffer from severe head pain with certain symptoms, you may be experiencing basilar migraine.

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What is a basilar migraine?

Basilar migraines are sometimes referred to as brainstem migraines because they begin in the brainstem, which is the lower part of the brain. This migraine often begins on one side of the head, with the pain gradually spreading and strengthening.

The typical duration of an MBA is anywhere from 4 to 72 hours, and recovery is usually achieved even after the migraine has subsided. Basilar migraine is unique in that most people experience an aura (dizziness, vision trouble, coordination issues) a few minutes before the onset of head pain.

MBA often presents in childhood or adolescence, though it can affect people at any age. In addition, women are more likely to experience this type of migraine than men.

What is an aura?

An aura is a type of visual sensation involving patterns of flashing lights, dots, or zig-zags that fluctuate in intensity. A scotoma is a specific type of aura typically involves blind or dark spots that slowly spread over the eye. 

A person will likely experience an aura or scotoma for between 5 minutes and an hour preceding a basilar migraine headache. Because of this distinctive symptom, basilar migraines are sometimes called scotoma migraines.

Symptoms of basilar migraines

Besides the aura or scotoma, a common symptom of basilar migraine is a buzzing pain at the back or on one side of the head, though a headache does not always occur. There are other potential symptoms as well, including:  

  • Confusion

  • Dizziness or vertigo

  • Double vision

  • Hearing difficulties

  • Light and sound sensitivity

  • Loss of balance

  • Loss of muscle control

  • Loss of consciousness

  • Nausea

  • Slurred speech

  • Temporary blindness

  • Tingling

  • Vomiting

If you experience any of these symptoms, consult your doctor right away.

What causes basilar migraine?

Recent studies¹ have found a strong link between MBA and genetic variations affecting ion channels in the brain. This is related to how easily nerves are activated and their reaction when stimulated. 

Whereas migraine was previously thought to be caused by blood vessel or inflammation problems, current evidence points to migraine as a nervous system disorder. Those who experience MBA often present increased responsiveness to stimulation of the nervous system.

Therefore, changes in a person’s environment, hormones, sleep patterns, and routine can stimulate the nervous system and trigger MBA as a response. Caffeine and stress have also been shown to be triggers of basilar migraine.

Treatment options

Most people who experience basilar migraines are focused on treating the symptoms and/or pain when the attack occurs. This may include over-the-counter and/or prescription medication to treat nausea, head pain, etc.

Some preventive medications may be effective for MBA. These include:

  • Botox

  • Beta-blockers (blood pressure medication)

  • CGRP treatments (Calcitonin Gene-Related Peptide)

  • Antidepressants

Other treatment options for those with MBA are chiropractic care, acupuncture, counseling, occupational therapy, and nutrition advice. Many people who experience migraine attacks find that a combination of medication and other treatment options provides the greatest effectiveness.

Ways to manage MBA

Thankfully, there are ways that people can manage migraines with brainstem aura. These strategies are part of an overall healthy lifestyle that can alleviate stress and enhance feelings of wellness.

  • Stay hydrated

  • Eat a well-balanced diet with plenty of fiber

  • Exercise regularly

  • Get adequate, consistent, and quality sleep

  • Set daily routines to reduce stress and over-stimulation

The lowdown

More research is being done about migraine, including basilar migraine, to determine causes and treatment methods.

If you experience symptoms of basilar migraine, schedule an appointment with your healthcare provider immediately. This way, you can receive a proper diagnosis and recommendations for effective treatment.

  1. Migraine is genetic | Migraine Australia

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