A basilar migraine, also known as a basilar-type migraine (BTM), is a subtype of migraine with aura symptoms originating from the brainstem or the simultaneous involvement of both hemispheres. This type of migraine is also referred to as basilar artery migraine, Bickerstaff syndrome, vertebrobasilar migraine and brainstem migraine.
BASILAR TYPE MIGRAINE SYMPTOMS
According to the American Headache Society, the symptoms experienced by BTM sufferers, in order from most to least common, are as follows:
100% of BTM patients describe having this symptom. 40% say they experience symptoms in both fields of vision while 60% only experience aura on one side or the other. Aura most commonly consists of a spinning sensation (vertigo), noise in the ears (tinnitus), double vision (diplopia), hearing problems (hypacusia), poor limb coordination (ataxia), and unpleasant sensations in the face arms or legs (ranging from prickling to stinging to burning). Temporary blindness can also occur, which is one reason BTM can be so scary.
98% of sufferers say they experience migraine-level headaches without aura, during aura, or within 60 minutes of aura symptoms occurring.
This is when the ability to speak, read or write properly is affected. 40% of basilar migraine patients report this symptom.
Each aura is different and each aphasic experience may be different from the next as well. These symptoms can be frightening, but understanding them will provide needed comfort when experiencing them.
HOW ARE BASILAR TYPE MIGRAINES DIAGNOSED?
A basilar type migraine diagnosis is made based on imaging tests, such as MRI and CT scan and possibly a lumbar puncture. It is possible that a diagnosis of basilar type migraine can be missed or delayed because it is rare and because symptoms can be similar to other migraine symptoms and conditions. A proper medical evaluation is performed to rule out other conditions and migraine types.
HOW ARE BASILAR TYPE MIGRAINES TREATED?
Basilar type migraines can be treated by numerous ways, which include:
- Biofeedback therapy to teach the patient how to monitor and respond to physical responses of an impending migraine attack
- Relaxation therapy to provide pain relief during a basilar migraine
- Cognitive behavioral therapy to help patients cope with stress and change the way their body reacts to anticipated migraine pain
- Anti-seizure drugs (topiramate, divalproex or valproate)
- Beta-blockers (propranolol, timolol or metoprolol)
- Antidepressants (amitriptyline or venlafaxine)