You’ve def heard of migraine before, and if you’re like 12 percent of the population, you’ve had one of those bad boys yourself. Cue head pain, nausea, and shrinking from the light like you’re a freaking vampire.
But what is a basilar migraine, and how is it different?
Basically, basilar migraine is a rare type of migraine that docs sometimes call a “migraine with brainstem aura” (MBA). Nope, this isn’t quite like the auras your crystal-collecting, tarot-reading BFF sees. These auras are triggered in the brain stem and can involve changes in:
Though experts don’t know for sure how many peeps get basilar migraine attacks, an estimate from 2019 suggests about 0.04 percent.
Let’s get to the bottom of identifying a migraine with brainstem aura and how to treat it.
During a migraine with brainstem aura or any type of migraine with an aura, you might experience:
- vision changes
- zigzagging or static lights
- stars or spots
- sensitivity to light or sound
- numbness of the face, hands, or head
Some aura symptoms are specific to MBAs, though, including:
- challenges speaking
- tinnitus (ringing in your ears)
- impaired hearing
- double vision
- impaired muscle control
- reduced consciousness
- tingling sensation
Whether stars, stripes, or squiggles, aura symptoms usually onset before the pain does and last anywhere from a few minutes to an hour. Afterward, an occipital headache (aka a headache in the back of your head that pierces, throbs or pulses) may last anywhere from hours to days. (Ouch.)
It’s rare that aura symptoms occur without a headache, but it can happen.
No one knows where auras come from for sure. But experts think that nerve abnormalities and/or altered blood flow to certain parts of the noggin may play a role.
Potential external triggers for migraine with brainstem aura include:
- nitrites in food (i.e. deli meat and bacon)
- excess hunger
- bright lights
- motion sickness
- strong smells
- swift weather or pressure changes
- headache medication overuse
- hormonal birth control pills
- hormone fluctuations in women
- blood pressure meds
- epilepsy or seizures
Those with a greater risk of MBAs include:
- People with a fam history of MBAs. About 80 percent of people with migraine also have a first-degree relative (parents, offspring, siblings) who gets them, which strongly suggests a genetic component.
- Women. The pros also know that more women get basilar migraine than men, though the exact stats are unknown.
- Children and teens. MBAs also tend to be more common in younger people, ages 7 to 20, according to a 2020 review.
- People with epilepsy. Those with epilepsy are also more likely to have migraine, especially those with aura-associated seizures, 2017 research suggests.
Vertigo’s one of the most common symptoms of MBAs.
Much like the movie poster for Hitchcock’s “Vertigo,” having vertigo basically makes you feel like you’re spiraling. Medically speaking, vertigo’s defined as the sensation that you or the environment around you is moving, spinning or shaking — even though it’s not.
Vertigo may make you:
- lose your balance
- feel dizzy
- have an upset stomach
Vertigo associated with migraine attacks with brainstem aura typically last from several mins up to an hour, but sometimes can last for days.
When vertigo’s the main symptom of the migraine (without aura symptoms), it’s sometimes a vestibular migraine.
The experts say it’s rare that a brainstem aura occurs without a headache. When it happens, though, it’s called a silent migraine: basically, one without head pain but with another migraine symptom like an aura.
Since aura symptoms may signal another more serious medical condition like epilepsy, it’s important to visit your doctor if you have them. They can also make everyday tasks like reading, driving, or cooking very challenging and potentially dangerous, so visit a pro to stay safe.
Basilar migraine stroke
Strokes and MBAs sometimes share similar symptoms. According to 2019 research, about 2 percent of people that docs initially evaluated as having a stroke end up being diagnosed with a migraine instead.
On the other hand, sometimes people having a stroke think they just have a migraine. Since strokes can be life-threatening, always call 9-1-1 if you or someone else experience any of the following:
- visual disturbances
- speech difficulties
- difficulty moving any part of your body
Though the link between migraine attacks and strokes still isn’t really understood, experts do know that those with a history of migraine with aura are about twice as likely to have strokes as those without a migraine history.
Migraine aura-triggered seizure
A migraine aura-triggered seizure is just like the (long-winded!) name suggests. Basically, it’s a rare disorder where a migraine with an aura triggers a seizure.
Sometimes called migralepsy, the condition’s defined by the following:
- a seizure diagnosed as an epileptic attack
- a seizure that happens to someone with migraine with aura
- the seizure happens during or within 1 hour after a migraine with aura episode
If you experience seizure-like symptoms after a migraine attack, always seek emergency medical care.
The link between seizures and migraine
According to the Epilepsy Foundation, people with seizure disorders are twice as likely to have migraine attacks and vice versa.
Since MBAs and seizures often share similar symptoms, they’re sometimes misdiagnosed as each other. Because of this, a doctor might use an electroencephalogram (EEG) to confirm the diagnosis.
To make matters more confusing, the two conditions often are caused by the same triggers, including:
Though the pros still don’t fully understand the link between seizures and migraine, there’s def something there.
If you think you’re suffering from MBA, visit a doctor for support.
Once you’ve had at least two basilar migraine episodes that meet certain criteria, a doc can diagnose you and get you the support you need. It’s also important to seek medical care since MBAs can mimic the symptoms of more serious conditions including:
- brain tumors
A doctor might use an MRI or a CT scan to rule out another condition.
Treating basilar migraine is all about reducing pain and managing symptoms. Your doctor might recommend:
- nonsteroidal anti-inflammatories like ibuprofen
- antiemetic meds that combat vomiting and nausea
- migraine drugs like verapamil, topiramate, triptan, or DHE
If over-the-counter (OTC) meds don’t work, your doc might prescribe something stronger like a nerve blocker to reduce the pain.
Since aura symptoms tend to develop before the pain, your doctor might tell you to pop those pills as soon as you notice warning signs. That will help them kick in before the throbbing begins.
They say prevention is the best medicine, and we say: true that. Since migraine treatment can be difficult, it’s often best to help mitigate triggers.
Certain lifestyle and diet changes may help prevent MBAs, including:
- Get enough sleep. Snoozing for at least 6 hours per night may help prevent migraine attacks, according to 2013 research.
- Eat healthy and avoid trigger foods. Alcohol, caffeine, and nitrites are just a few common trigger foods and drinks for those who deal with migraine. With help from a doctor, you also might identify certain foods that spur your symptoms. To prevent migraine attacks, keep track of your diet, avoid trigger foods, and eat as healthfully as possible.
- Keep a migraine diary. Doctors often recommend keeping a headache diary to keep tabs on your symptoms including frequency, duration, severity, and triggers. Figuring out what sets off your migraine attacks is an important step in stopping them.
- Acupuncture, massage, essential oils. Researchers say that acupuncture, massage and other alternative medicine techniques can sometimes help prevent basilar migraine attacks. There’s some anecdotal evidence that essential oils or even daith piercings just might work, too, but that could all just be a placebo effect.
- Therapy. In a 2015 study, researchers found cognitive behavioral therapy, biofeedback techniques, and stress management to be effective ways to prevent chronic migraine in adults. Scientists say therapy works for basilar migraine, too.
- When a migraine attack starts, stop right there. As soon as you notice aura symptoms, head to a dark, quiet, and comfy room if possible. Place an ice pack on your neck, take some deep breaths and relax. Pro tip: pack a migraine kit so you’ll always be prepared.
Since there’s no tried-and-true treatment for migraine with brainstem aura (though your doc might recommend OTC or prescription meds), prevention’s often the best medicine.
Rest, diet, and lifestyle changes can help prevent MBAs before they onset. Keep a migraine diary and work with a medical professional to find what works best for you.
If you experience speech difficulties, visual disturbances, or numbness during a migraine episode, seek emergency care. These symptoms could signal something more serious like a seizure.