Basilar migraine or “migraine with brainstem aura” is a rare form of migraine which is accompanied by dysfunction of the brainstem ( Box 6.2 ). Typically, sufferers report non-positional vertigo, diplopia, and dysarthria. Often, a mild or significant change in level of consciousness is noted. Other symptoms include hypacusis, tinnitus, and
aura visual symptoms and about a thirdhave osmophobia or hyperosmia.12,13 Vertigo can be present during attacks of migraine, or can constitute the defining symptom of vestibular migraine, or a prominent symptom of migraine with brainstem aura. 14 Over 70% of patients have cutaneous allodynia—the perception of pain when nonÂpainful Migraine without aura develops in phases: Premonitory phase: A person may experience symptoms such as fatigue, muscle stiffness, constipation, food cravings, mood changes, and sensitivity to light Migraine with brain stem aura. Also known as basilar migraine , this is a rare type of migraine where aura symptoms originate in the brain stem . Symptoms can include vertigo , ringing in the ears For a diagnosis of migraine with aura, the following criteria must be met: One or more visual, sensory, speech, motor, brainstem, or retinal symptoms, as well as at least 2 of the following 4 criteria: (1) at least 1 aura symptom spreading gradually over 5 or more minutes and/or 2 or more symptoms occurring in succession; (2) each aura symptom lasting 5–60 minutes; (3) at least 1 aura Migraine without aura: A clinical syndrome characterized by headache with specific features and associated symptoms; Brainstem migraine: When the aura starts in the brainstem (base of the brain) Hemiplegic migraine: A rare type in which aura causes hemiplegia (weakness on one side of the body) Symptoms. Migraines, which affect children and teenagers as well as adults, can progress through four stages: prodrome, aura, attack and post-drome. Not everyone who has migraines goes through all stages. Prodrome. One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including: Constipation. The understanding of migraine pathophysiology is advancing rapidly. Improved characterisation and diagnosis of its clinical features have led to the view of migraine as a complex, variable disorder of nervous system function rather than simply a vascular headache. Recent studies have provided important new insights into its genetic causes, anatomical and physiological features, andmigraine with brainstem aura symptoms
