Understanding and Treating Basilar-Type Migraine (BTM)- Part I

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Basilar-Type Migraine (BTM) headaches are not your average migraine headache- while many migraines with aura cause symptoms like dizziness, visual distortions, and nausea that can last for 30 minutes, basilar-type migraine attacks come on stronger and more aggressively.  Typical BTM auras include severe vertigo, speech slurring, and impaired walking, lasting up to two hours before shifting into migraine headache mode.


Basilar-type migraines- what are they?

Basilar-type migraines are migraines with aura that originate in the brainstem or both sides of the brain (cerebral hemispheres).  Previously, they used to be referred to as basilar artery migraines (BAM) because some researchers thought they were caused by the narrowing of the basilar artery at the back of the brain.

Most basilar-type migraines follow the pattern of typical migraines with aura, the only difference being increased severity, duration, and frequency of aura symptoms such as vertigo, disorientation, and speaking difficulties.

Another distinguishing characteristic of basilar-type migraines is the absence of any sign of motor weakness, such as numbness or paralysis that can occur with other types of migraines with aura.

It was previously believed that basilar-type migraines occurred mostly among young teenaged girls, but we know understand that it can affect migraine sufferers of any age group.  And like all migraines, women are three times more likely to suffer from basilar-type migraines as males.


Migraines and other Types of Headaches- How many are there? Part 1

Symptoms of basilar-type migraines

About one or two hours before the migraine headache sets in, most patients with basilar-type migraines experience a typical migraine aura, only much stronger than average migraine with aura symptoms.  At first glance, somebody suffering from a BTM aura may appear to be intoxicated, as slurred speech, dizziness, and walking difficulties are common symptoms.

Basilar-type migraine aura symptoms include:

  • Vertigo
  • Visual aura (bright spots, flashes, or crescent-shaped images)
  • Double vision
  • Blurred vision
  • Temporary blindness
  • Aphasic aura (slurred speech)
  • Difficulty controlling your tongue, jaw, or throat muscles
  • Ataxia (loss of balance while walking)
  • Paresthesias (numbness or “pins and needles” in the face, hands, or feet)
  • Confusion
  • Nausea
  • Vomiting
  • Tinnitus (ringing in the ears) or other hearing impairment
  • Loss of consciousness

Please tell us…

Do you suffer from basilar-type migraines?  What migraine treatments are you currently using, and which ones are the most effective?  Do you have any symptoms that are not covered by this article?  We welcome your comments, suggestions, and questions!

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Read more about migraine treatments:

Migraine Headache Frequently Asked Questions- the Top Ten List

Migraine Pop Quiz: How Well do you Understand your Headaches?

4 Headaches that Require Emergency Intervention


Basilar-Type Migraine- ACHE