Basilar artery migraines, also known as migraines with brainstem aura, are a rare but complex type of migraine. Unlike typical migraines, they affect the lower part of the brain called the brainstem. These migraines bring intense neurological symptoms like vertigo, double vision, difficulty speaking, ringing in the ears, and sometimes even short-term loss of consciousness.

Though alarming, basilar artery migraines are treatable. The goal is to manage symptoms, reduce their frequency, and improve quality of life through personalized treatment plans. In this blog, we explore Basilar Artery Migraine Treatments, their triggers, prevention strategies, and how to navigate this condition effectively.

Understanding Basilar Artery Migraine

A basilar artery migraine is not caused by blocked or narrowed arteries, despite the name. Instead, it’s a type of migraine with aura where symptoms originate from the brainstem. These migraines typically occur in adolescents and young adult women but can affect individuals of any age.

The aura phase precedes the headache and includes symptoms like dizziness, slurred speech, vision problems, and confusion. These signs are reversible but can disrupt daily life and cause fear or misdiagnosis.

Common aura symptoms include:

  • Vertigo (a spinning sensation)
  • Double vision (diplopia)
  • Tinnitus (ringing in the ears)
  • Speech difficulties (dysarthria)
  • Impaired coordination
  • Hearing loss
  • Confusion
  • Temporary loss of consciousness

These symptoms often fade before the headache sets in. Not everyone with a basilar migraine experiences all symptoms, but they usually appear in combination.

Basilar Artery Migraine Causes and Triggers

basilar artery migraine symptoms

The precise cause of basilar artery migraine remains unclear. It’s believed to be linked to abnormal electrical activity in the brainstem, rather than issues with blood vessels. While genetics may play a role, environmental triggers are commonly responsible for attacks.

Common triggers include:

Tracking these triggers in a migraine diary can be helpful when developing a treatment plan.

Diagnosing Basilar Artery Migraine

Understanding Basilar Artery Migraine Symptoms

Diagnosing this condition starts with a detailed medical history and physical exam. Neurologists rely on the International Classification of Headache Disorders (ICHD-3) criteria to confirm a diagnosis.

You may be diagnosed with a basilar artery migraine if:

  • You’ve had at least two attacks with aura symptoms from the brainstem (not affecting motor control)
  • The aura is followed by a headache
  • No other condition explains the symptoms

To rule out other neurological problems like stroke or tumor, doctors may order imaging tests such as MRI or CT scans. An EEG may also be recommended to observe brain activity.

Accurate diagnosis is crucial because the treatment for basilar migraines differs significantly from that of other migraine types.

Basilar Artery Migraine Treatments Options

Now let’s focus on the heart of this article: Basilar Artery Migraine Treatments. Managing this condition involves acute relief, preventive strategies, and long-term lifestyle adjustments.

1. Acute Treatment: Managing Attacks

During an active migraine, the goal is to reduce pain and manage symptoms like nausea or dizziness. Over-the-counter pain relievers can be effective for mild episodes.

Common medications include:

  • Ibuprofen
  • Naproxen
  • Acetaminophen

For nausea or vomiting:

  • Metoclopramide or prochlorperazine (anti-emetics)

Important note: Triptans and ergotamines, often used for typical migraines, are not advised in basilar artery migraine treatments. These medications constrict blood vessels and could potentially worsen the condition.

2. Preventive Treatment: Reducing Frequency and Severity

If migraines occur frequently or are particularly severe, preventive medications may be prescribed. These are typically taken daily and are designed to reduce how often migraines happen and how bad they get.

Preventive medications include:

  • Verapamil (a calcium channel blocker)
  • Topiramate (an anti-epileptic drug)
  • Beta-blockers (like propranolol)
  • CGRP inhibitors (a new class of drugs designed specifically for migraine prevention)
  • Botox injections (for chronic migraine sufferers)

Preventive treatment is a cornerstone in managing basilar artery migraine treatments, especially in patients with debilitating symptoms.

3. Nerve Blocks

In some cases, doctors may recommend nerve block injections. These involve injecting a local anesthetic near nerves in the neck or head to “block” pain signals. Nerve blocks offer temporary but effective relief, especially when other treatments fail.

Lifestyle Modifications

Medications alone are not always enough. Lifestyle plays a crucial role in managing basilar artery migraine treatments. Adopting healthy habits can reduce attacks significantly.

Helpful lifestyle changes include:

  • Regular Sleep: Aim for 7–8 hours per night. Inconsistent sleep is a major trigger.
  • Balanced Diet: Avoid skipping meals, processed foods, and known dietary triggers.
  • Hydration: Dehydration can provoke migraines—drink plenty of water daily.
  • Exercise: Engage in moderate physical activity like yoga or walking.
  • Stress Management: Practice mindfulness, meditation, or breathing exercises.
  • Limit Screen Time: Too much exposure to screens or bright lights can act as a trigger.

Tracking triggers and daily habits in a journal helps patients and doctors fine-tune the most effective basilar artery migraine treatments.

Differential Diagnosis

Because of its wide-ranging symptoms, basilar artery migraine can be confused with other serious conditions. Ruling these out is an essential part of diagnosis.

Conditions to differentiate include:

  • Stroke or transient ischemic attack (TIA)
  • Meniere’s disease (inner ear condition)
  • Vestibular disorders
  • Brainstem tumor
  • Epilepsy
  • Meningitis

These are typically ruled out through MRI, CT scans, and additional testing to confirm a basilar migraine diagnosis.

Prognosis and Stroke Risk

The good news is that most people with basilar artery migraines improve with age. Many patients find that aura symptoms decrease in frequency or stop altogether over time.

That said, there is a slightly higher risk of stroke in individuals with migraines with aura. To minimize this risk:

  • Avoid smoking
  • Discuss non-estrogen birth control options with your doctor
  • Keep blood pressure, cholesterol, and diabetes under control
  • Exercise regularly and manage weight

Complications like persistent neurological symptoms or increased sensitivity to triggers may develop, but these can often be managed with consistent treatment.

Conclusion

Basilar artery migraines may be rare and challenging, but they are not insurmountable. With the right combination of medication, lifestyle changes, and medical guidance, many individuals can live symptom-free or drastically reduce the impact of their condition.

Whether you’re newly diagnosed or seeking better control, understanding basilar artery migraine treatments is your first step toward relief. Early intervention, self-awareness, and personalized care plans can dramatically improve your quality of life.

If you suspect you may be experiencing this type of migraine, don’t delay in consulting a neurologist. Prompt diagnosis and treatment can help prevent complications and allow you to take control of your health.

FAQ

What is the treatment for basilar migraine?

Basilar migraines are typically treated with NSAIDs, anti-nausea medications, and preventive drugs like verapamil or topiramate. Triptans are usually avoided.

How long does a basilar migraine last?

Aura symptoms usually last 15 minutes to an hour. The headache phase can persist for several hours or even a full day.

What’s the best way to stop migraines?

A combination of medication, lifestyle adjustments, and trigger management is most effective. Preventive therapies can also help.

What is the new name for basilar migraine?

The updated term is “migraine with brainstem aura,” as classified by the International Headache Society.

Can migraines cause unconsciousness?

Yes, in rare cases, basilar migraines can cause temporary loss of consciousness due to brainstem involvement.

Can migraines go away permanently?

Some individuals experience fewer migraines with age or with successful long-term treatment, though not everyone finds complete relief.