Basilar migraines are headaches that start in the lower part of the brain, called the brainstem. They cause symptoms such as dizziness, double vision, and lack of coordination. These changes, called an aura, can happen about 10 minutes to 45 minutes before your head hurts. The headache pain of a basilar migraine often starts on one side of the head and then gradually spreads and gets stronger.
This type of migraine can last anywhere from 4 to 72 hours. And it takes time to recover from one. You may feel drained for up to 24 hours after it’s over.
Basilar migraines are known by several different names:
- Basilar artery migraine
- Basilar-type migraine
- Bickerstaff's syndrome
- Brainstem migraine
- Vertebrobasilar migraine
Who's at Risk for Basilar Migraines?
Basilar migraines can affect people of all ages. Generally, though, they start in childhood or the teen years. Women are slightly more likely to have them than men.
What Causes Basilar Migraines?
Triggers may include:
- Lack of sleep
- Some medications
- Female hormone changes
- Bright lights
- Nitrites in some foods, like sandwich meat, bacon, and processed foods
- Overdoing physical activity
- Weather or altitude
What Are the Symptoms of Basilar Migraines?
Symptoms differ for everyone, but some are typical:
- Sensitivity to light and sound
- Cold hands or feet
- Double vision or graying of vision
- Slurred speech or trouble speaking
- Temporary blindness
- Loss of balance
- Trouble hearing
- Body tingling
- Loss of consciousness
Aura symptoms may last between 5 minutes and 1 hour. When the headache starts, you might feel an intense throbbing or pulsating pain on one or both sides of your head or sometimes at the back of your head.
How Are Basilar Migraines Diagnosed?
After you’ve had at least two attacks of at least two auras, your doctor can diagnose you with a basilar migraine.
Symptoms of basilar migraines can also seem like the signs of other more serious conditions, like seizure disorders, stroke, meningitis, or brain tumors. To rule those out, you’ll need to see a brain doctor, called a neurologist. He’ll give you a thorough exam and ask you questions about your symptoms. He’ll also use tests like MRI, CT scans, and nerve tests to see what’s causing your symptoms.
How Are Basilar Migraines Treated?
Treatments for basilar migraines generally aim to relieve symptoms of pain and nausea. You might take pain relievers such as acetaminophen, ibuprofen, and naproxen, as well as nausea medicines such as chlorpromazine, metoclopramide, and prochlorperazine. Your doctor may prescribe a medication that treats regular migraines, such as triptans.
Can Basilar Migraines Be Prevented?
To keep from getting a basilar migraine, it helps to avoid the things that usually cause one. Keep a journal of your attacks so you can figure out the things that trigger them. It also helps to live a healthy lifestyle. That means you need to:
Diet can also affect migraines. Do these things:
- Eat a balanced diet.
- Avoid drugs and alcohol.
- Don’t skip meals.
- Limit caffeine.
- Avoid any foods that have been triggers.
Some common food triggers include:
Along with these changes, your doctor might prescribe the same preventive medications that work for regular migraines. These include seizure medicines such as topiramate (Topamax) or valproic acid (Depakote). Other drugs, called calcium channel blockers, work by keeping blood vessels narrow and by blocking your body from giving off a chemical called serotonin. Some antidepressants also block serotonin, so you might take one for your migraines, too.