basilar type migraine

30 September 2013

Do I have Migraine with Brainstem Aura?

Migraine with Brainstem Aura (MBA) is a type of Migraine with Aura.
Formerly called Basilar Migraine, Basilar Artery Migraine, or Basilar-type Migraine.

MBA not only includes typical migraine aura symptoms (visual symptoms, language difficulty, etc), and usually headache, but also “brainstem aura”.

Brainstem aura may include:

vertigo
dysarthria (trouble controlling speech muscles)
hearing impairment
double vision
decreased level of consciousness

Each symptom lasts less than an hour.
(Motor weakness is not a part of MBA)

Note: We will be starting to work through some of the changes that will be in the new headache classification document from the International Headache Society. One of the changes will be a name change – from basilar-type migraine to migraine with brainstem aura. MBA is a rare type of migraine which often includes very disabling and severe types of aura. When motor weakness is present – muscle weakness which may make it difficult to walk – the diagnosis will instead be a type of hemiplegic migraine.

The graphic above is not intended to help you make a diagnosis, but just to point you in the right direction – to better understand from your symptoms what you may be dealing with.

6 May 2013

What is Migraine Associated Vertigo?

James Information 2

MAV is a possible symptom of migraine disease (not a type of migraine).

Vertigo: the world is moving or spinning around you

About 25%-35% of migraineurs experience vertigo.
It’s usually accompanied by other migraine symptoms.

Patients need a proper diagnosis. Is it migraine? if so, what type?

MAV is often a symptom of:

Basilar-type Migraine
Familial Hemiplegic Migraine
Migraine with Aura

For more information:

11 April 2009

Basilar-type Migraine – Strangest Migraine on the Block?

James Information 13

It’s one of the strangest types of migraine around: Basilar type migraine.

People with this type of migraine can be misdiagnosed very easily. They might be diagnosed with epilepsy. Or, they might even appear to be drunk, or under the influence of drugs!

Since it’s first diagnosis in 1961, we’ve learnt a lot about basilar type migraine. For one thing, we know that a spasm of the basilar artery is not the root of the problem (hence the name change from basilar artery migraine to basilar type migraine (BTM)).

Unlike many migraine attacks, attacks from BTM are often two-sided. The throbbing headache is at the back of the head.

Unlike hemiplegic migraine, BTM doesn’t involve motor weakness. But the symptoms can be pretty severe.

The visual aura can be severe enough to cause temporary blindness. Then there can be problems with coordination, dizziness, double vision, jerky eye movements, trouble hearing, slurred speech, nausea, pins and needles. Usually the attacks are short (lasting less than an hour), but they have been known to go on for days. Sometimes the strange symptoms come in succession, one after another. Some patients even lose consciousness!

Special concerns about basilar type migraine? The symptoms can be confused with other serious conditions, for one thing, so your doctor may call for more tests than would be normal with migraine. Also, there’s concern that those with BTM may have a greatly increased chance of stroke.

Basilar type migraine is treated in similar ways to other types of migraine. However, some doctors avoid triptans, ergotamines and beta-blockers. Because of the rarity of BTM, fewer studies have been done (I do have at least one friend who has it, though!).

See the National Headache Foundation’s brief article on basilar type migraine.

25 October 2008

Vestibular Migraine – Why the confusion?

James Information 5

It’s been in the news a lot lately – vestibular migraine. You can be excused if you’ve never heard of such a thing before. It’s not that lots of people don’t have it – in fact, I have a friend that does. The confusion lies in the name.

Vestibular Migraine is not the official name of any type of migraine at all. It’s better to see it as a description – a migraine with certain symptoms. The name is used, but rarely because it’s not listed in the official list of classifications from the International Headache Society.

The word "vestibular" simply means having to do with equilibrium. So, as you may guess, a migraine attack which is vestibular involves symptoms such as vertigo, dizziness, motion sensitivity, etc. (more on vestibular migraine symptoms from Johns Hopkins).

So we’re not going to say there’s "normal" migraine and "vestibular" migraine, as if there are two types. Migraine is a disease with a host of symptoms. Often those symptoms allow us to narrow down which treatment will work the best. Migraine disease has been broken down into many different types.

The type of migraine most commonly associated with vertigo is called basilar-type migraine (formerly called basilar migraine or basilar artery migraines). Vertigo is common in basilar type migraine, as is ringing in the ears, unsteadiness, visual symptoms, and sometimes a decreased level of consciousness. Another type of migraine, familial hemiplegic migraine, sometimes has similar symptoms, except with motor weakness added on. In both cases there is usually a headache.

Vestibular migraine can also be a form of migraine with aura, when the aura is vertigo or dizziness. In fact, many migraineurs experience dizziness, but when it becomes particularly overwhelming and severe, that’s when we start using the word "vestibular".

And remember, these types of migraine attacks involve lots of other symptoms beyond headache, vertigo and dizziness (such as the symptoms mentioned above). Most migraine attacks can be debilitating for a host of reasons, not just because of the headache pain. Even if there is no headache pain, the vertigo or dizziness can be frightening, and this and the many other symptoms can shut you down completely during an attack.

One type of headache that sometimes comes with dizziness is an MSG headache. MSG headache can be a migraine or not.

If you are having vestibular symptoms, it’s important not to make assumptions. See your doctor and have other causes ruled out first. (Sometimes an EEG is helpful in cases like these). Then you can investigate treatments, which generally are common to most types of migraine.

Sometimes regular migraine treatments can alleviate all the symptoms, but sometimes the vertigo remains. It’s possible to take medication for the vertigo as well.

Vestibular migraine - vertigo, dizziness, and more...

19 September 2005

Vertigo – could it be migraine?

James Resources, Tips 22

Vertigo, the feeling that the world is spinning or that you’re about to fall, often goes hand in hand with headaches. Neurologist Dr Lee Moon Ken recently wrote this helpful article about vertigo, in which he talks among other things about the connection to headache.

In their book Migraine and Other Headaches, Drs Young and Silberstein write about a girl who experienced extreme problems with vertigo: …she began seeing double. This lasted for about a minute. She began to feel like the room was spinning and then she passed out…

This girl had a basilar type migraine, also known as Bickerstaff Syndrome. The symptoms can be serious enough, as you can tell. But vertigo can indicate a more immediate life threatening problem, and isn’t something that should be ignored.

Vertigo by itself could even indicate migraine. As you should know, migraine attacks do not always involve pain. It’s worthwhile to know your family history and consider whether you may have migraine if you’re getting vertigo.

You can read a portion of an eMedicine article on migraine and vertigo here.