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Basilar-Type Migraine

Reviewed by: HU Medical Review Board | Last reviewed: October 2020

Basilar migraine is recognized as a distinct type of migraine disorder. However, basilar migraine is an old term for what is now called migraine with brainstem aura. It is a subtype of migraine with aura and has many of the same symptoms as migraine with aura.

The name basilar migraine came from the old belief that this type of migraine was caused by the short-term narrowing of the basilar artery. This led to the name basilar artery migraine, basilar migraine, and basilar-type migraine. Now doctors know that it is caused by nerves at the base of the brain (brainstem) or nerves on both sides of the brain (cerebral hemispheres).1,2

Basilar migraine symptoms

People with migraine with brainstem aura (basilar migraine) attacks describe these episodes as:1,2

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The symptoms may last just a few minutes and usually end after 1 hour. Usually, these symptoms are followed by head pain. Unlike most other types of migraine, the pain is often in the occipital region, which is at the base of the skull. Also, basilar migraine pain might not be a throbbing pain. Some people with basilar migraine feel dizzy or have problems with muscle coordination after their migraine attack.

Other basilar migraine symptoms

  • Speech symptoms, such as poor articulation, difficulty moving the tongue and the jaw, swallowing problems
  • Lightheadedness
  • Hearing loss
  • Numbness or tingling on both sides
  • Fainting

Because they share many symptoms in common, basilar migraine is sometimes mistaken for familial hemiplegic migraine and sporadic hemiplegic migraine. However, with basilar migraine, people report no muscle weakness.

Treatments for basilar migraine

The most common treatments for migraine with brainstem aura, also known as basilar migraine, include:1

  • Pain killers, such as acetaminophen or ibuprofen, and antinausea drugs for acute treatments (after the migraine has started)
  • Preventive treatments such as topiramate, verapamil, and lamotrigine

Drugs that are often prescribed for other types of migraine are not recommended for people who have migraine with brainstem aura. These drugs include triptans, ergotamines, and beta-blockers1