Basilar-Type Migraine: Rare Condition with Alarming Symptoms

Learn the symptoms, diagnosis and treatment for basilar-type migraine

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Basilar-type migraine, also sometimes called basilar artery migraine, is a frightening form of migraine with aura that can mimic a stroke, with slurred speech, numbness and vertigo.

Unlike most migraines, basilar-type migraine produces an aura simultaneously in both eyes (bilateral aura). This aura can result in temporary blindness.

Fortunately, basilar-type migraine is rare, affecting about 10% of all migraine with aura patients in one study.

However, the disorder can be disabling and difficult to treat, because commonly used migraine medications generally aren't used for basilar-type migraine.

Symptoms of Basilar-Type Migraine

Basilar-type migraine often, but not always, features the bilateral aura and pain on both sides of your head. To be diagnosed with this type of migraine, you must have at least two of these symptoms:

  • bilateral aura
  • vertigo
  • speech slurring
  • ringing in your ears
  • impaired hearing
  • double vision
  • loss of full control of body movements
  • decreased level of consciousness

In addition, your aura symptoms must last for at least five minutes, but for no more than an hour. When your migraine pain hits, it may be centered at the base of your skull instead of on one side of your head.

It's most common to show the first symptoms of basilar-type migraine in your teens or 20s, although children and older people can develop the condition as well.

As with other forms of migraine disorder, women are much more likely than men to have basilar-type migraine, and there have been some reports of this type of migraine being associated with menstruation.

Migraine triggers often are involved with basilar-type migraine attacks. One study found that nearly three-quarters of people with the condition had migraine attacks triggered by "intense emotional stimuli," while sleep disorders affected more than half.

Changes in weather, bright sunshine, cold wind, stress and alcohol also were cited as triggers.

Diagnosing and Treating Basilar-Type Migraine

Basilar-type migraine symptoms can mimic a variety of serious conditions, including stroke, epilepsy, brain tumors, congenital defects of the brain stem and poor blood flow to the brain. Because of this, your doctor may recommend a CT scan or MRI to rule out other conditions before diagnosing basilar-type migraine.

In addition, since basilar-type migraine is so uncommon, you may find it helpful to see a migraine specialist to diagnose or treat your condition.

Triptans, a commonly prescribed migraine medication, many not be suitable for basilar-type migraine. Some clinicians have seen success with Lamictal, a prescription drug used to treat epilepsy and bipolar disorder, or with different anti-epileptic drugs, such as Topamax.

Other physicians may treat the condition with what's called a greater occipital nerve block. This involves a simple procedure in which steroids are injected into the back of your head.

This shot can relieve the pain temporarily, for up to about three months, and can be repeated.


Baron EP et al. Acute treatment of basilar-type migraine with greater occipital nerve blockade. Headache. 2010 Jun;50(6):1057-9.

Cologno D et al. Basilar-type migraine patients responsive to lamotrigine: a 5-year follow-up. Neurological Sciences. 2013 May;34 Suppl 1:S165-6.

The International Headache Society. "International Classification of Headache Disorders, 2nd Edition." Cephalalgia, Volume 24 Issue s1. May, 2004. doi:10.1111/j.1468-2982.2003.00823.

The Migraine Trust. "Basilar-type Migraine - 2012." Accessed Nov. 30, 2015

Ying G et al. Clinical characteristics of basilar-type migraine in the neurological clinic of a university hospital. Pain Medicine. 2014 Jul;15(7):1230-5.

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