Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisPreventionTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Prevention
Treatment
Fortunately, this type of migraine is relatively rare. According to one of the fewstudieslooking at the incidence of migraine with brainstem aura, only about 10 percent of people who get migraine with aura experience this particular subtype.
The best treatments also are somewhat elusive, but as more is understood about the condition, the better able healthcare providers will be to help patients manage it.
Verywell / Emily Roberts
Migraine with brainstem aura must also involve at least two of the following:
Note, however, that weakness or paralysis on one side of the body in addition to any of these symptoms leads to a diagnosis ofhemiplegic migrainerather than MBA; vision loss or other changes that affect only one eye is indicative ofretinal migraine.
Usually, as with most migraine with aura disorders, the aura will subside as the headache kicks in. In the case of migraine with brainstem aura, head pain typically is concentrated in the back of the head and affects both sides—the approximate location of the brainstem and structures (blood vessels and nerves) that support it.
When Bickerstaff identified MBA, he hypothesized that a temporary narrowing or spasm of the basilar artery (actually two conjoined vertebral arteries) that supplies blood to the brainstem was the cause. The brainstem controls vision, hearing, movement, and vital functions such as heart rate, breathing, and blood pressure. This theory has never been proven.
Scientists further think abnormalities of nerves and/or altered blood flow to the brainstem, as well as the occipital lobes, may play a role in the development of MBA.
There are no specific tests for diagnosing migraine with brainstem aura. Instead, a healthcare provider will rely on a physical exam and a medical history to assess such things as your ability to think clearly, your physical strength, reflexes, vision, and nerve function.
Also, since migraine with brainstem aura can mimic a variety of other serious conditions, includingstroke,epilepsy,brain tumor, congenital defects of the brain stem, and poor blood flow to the brain, certain tests may be needed to rule these out, as well as to eliminate other types of migraine with aura, includinghemiplegic migraineandretinal migraine.
A healthcare provider may order tests such as:
Diagnosing Migraines
As with most types of migraines, dealing with those with brainstem aura involves a combination of taking measures to keep them from occurring and using medication to relieve symptoms when prevention fails.
Once you’re diagnosed, you and your healthcare provider will need to work together to find a regimen that works best for you.
One of the best ways to identifywhat triggers migrainesof any type is to keep a record of each time one hits, including any factors that may have preceded it, such as an exceptionally stressful day or consumption of a particular food. Eventually, a pattern may emerge that reveals triggers that are specific to you, which can help you take steps to avoid them.
How to Keep a Headache Diary
Certain medications can help prevent migraine with brainstem aura as well. Those used most often include:
In most cases, the same medications used to treat other types of migraine headache symptoms—namely pain, nausea, and vomiting—are effective for migraine with brainstem aura.
Pain medications (analgesics):These include non-steroidal anti-inflammatory drugs (NSAIDs), including over-the-counter Advil and Motrin (ibuprofen) and Tylenol (acetaminophen), or prescription-strength versions of these drugs.
Antiemetics (anti-nausea):Medications to treat nausea, such as phenothiazine, may be used to treat migraine with brainstem aura.
Calcitonin gene-related peptide (CGRP) antagonists:These include Ubrelvy (ubrogepant), Nurtec ODT (rimegepant),Zavzpret (zavegepant), and may be used to treat acute migraine with brainstem aura.
Triptans:Triptans are usually not recommended to treat patients with migraine with brainstem aura, due to concerns that these medications may cause cerebral ischemia in this group of patients—although this is still somewhat controversial. The same applies to the use of ergotamine derivatives.
All About Triptans
Greater occipital nerve block:This is a procedure in which a local anesthetic and/or steroid is injected into a nerve located in the back of the neck. This shot can relieve the pain temporarily for up to about three months and can be repeated.
Peripheral Nerve Blocks for Headaches
A Word From Verywell
Migraine with brainstem aura can be unsettling. And for those who have this type of attack frequently, the condition can be debilitating. Fortunately, once stroke, seizure disorders, brain tumors, and other serious concerns have been ruled out as the cause of symptoms, and it’s clear that you are dealing with a migraine disorder, there are multiple options available for preventing episodes and, if they do occur, treating them.
SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Genetic and Rare Diseases Information Center. NIH.Migraine with Brainstem Aura. June 15, 2016.Kirchmann M, Thomsen LL, Olesen J.Basilar-type Migraine: Clinical, Epidemiologic, and Genetic Factors. Neurology. 2006 Mar:66(6):880-886 doi: 10.1212/01.wnl.0000203647.48422.ddRobertson, CE.Migraine with Brainstem Aura (Basilar-Type Migraine). UpToDate. Dec 2018.The International Headache Society.International Classification of Headache Disorders, 3rd Edition.Cephalalgia, Volume 24 Issue s1. May, 2004. doi:10.1111/j.1468-2982.2003.00823.Ying G, Fan W, Li N, et al.Clinical Characteristics of Basilar-type Migraine in the Neurological Clinic of a University Hospital. Pain Med. 2014 Jul;15(7):1230-5. doi: 10.1111/pme.12402
Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Genetic and Rare Diseases Information Center. NIH.Migraine with Brainstem Aura. June 15, 2016.Kirchmann M, Thomsen LL, Olesen J.Basilar-type Migraine: Clinical, Epidemiologic, and Genetic Factors. Neurology. 2006 Mar:66(6):880-886 doi: 10.1212/01.wnl.0000203647.48422.ddRobertson, CE.Migraine with Brainstem Aura (Basilar-Type Migraine). UpToDate. Dec 2018.The International Headache Society.International Classification of Headache Disorders, 3rd Edition.Cephalalgia, Volume 24 Issue s1. May, 2004. doi:10.1111/j.1468-2982.2003.00823.Ying G, Fan W, Li N, et al.Clinical Characteristics of Basilar-type Migraine in the Neurological Clinic of a University Hospital. Pain Med. 2014 Jul;15(7):1230-5. doi: 10.1111/pme.12402
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Genetic and Rare Diseases Information Center. NIH.Migraine with Brainstem Aura. June 15, 2016.Kirchmann M, Thomsen LL, Olesen J.Basilar-type Migraine: Clinical, Epidemiologic, and Genetic Factors. Neurology. 2006 Mar:66(6):880-886 doi: 10.1212/01.wnl.0000203647.48422.ddRobertson, CE.Migraine with Brainstem Aura (Basilar-Type Migraine). UpToDate. Dec 2018.The International Headache Society.International Classification of Headache Disorders, 3rd Edition.Cephalalgia, Volume 24 Issue s1. May, 2004. doi:10.1111/j.1468-2982.2003.00823.Ying G, Fan W, Li N, et al.Clinical Characteristics of Basilar-type Migraine in the Neurological Clinic of a University Hospital. Pain Med. 2014 Jul;15(7):1230-5. doi: 10.1111/pme.12402
Genetic and Rare Diseases Information Center. NIH.Migraine with Brainstem Aura. June 15, 2016.
Kirchmann M, Thomsen LL, Olesen J.Basilar-type Migraine: Clinical, Epidemiologic, and Genetic Factors. Neurology. 2006 Mar:66(6):880-886 doi: 10.1212/01.wnl.0000203647.48422.dd
Robertson, CE.Migraine with Brainstem Aura (Basilar-Type Migraine). UpToDate. Dec 2018.
The International Headache Society.International Classification of Headache Disorders, 3rd Edition.Cephalalgia, Volume 24 Issue s1. May, 2004. doi:10.1111/j.1468-2982.2003.00823.
Ying G, Fan W, Li N, et al.Clinical Characteristics of Basilar-type Migraine in the Neurological Clinic of a University Hospital. Pain Med. 2014 Jul;15(7):1230-5. doi: 10.1111/pme.12402
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