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Migraine with Brainstem Aura

Migraine with brainstem aura is also called brainstem migraine and was previously called basilar type migraine. This rare and serious sub-type of migraine can involve a number of concerning symptoms that originate from the brainstem.


Migraine with brainstem aura is so rare there are very few studies on it. The symptoms will include two or more of the following:

  • visual disturbances in both eyes
  • speaking difficulties, particularly slurry speech
  • hearing problems or ringing in the ears (tinnitus)
  • tingling in the hands and feet
  • being unsteady while walking or having difficulty controlling your movement (ataxia)
  • extreme fatigue
  • dizziness and/or vertigo
  • disorientation
  • confusion
  • decreased consciousness including fainting and, in rare cases, coma.

The tell-tale indicator that someone may have migraine with brainstem aura is a different headache: it is at the back of the head, commonly right at the base of the skull, and is more buzzing than pulsating. The symptoms are more frightening than harmful, but there is a slightly higher risk of stroke, so optimal prevention and knowledge of stroke risk factors and their control is important.

Anyone can be affected by migraine with brainstem aura, but it is most commonly diagnosed in adolescent girls. For those with this subtype, aura may increase in later life.

Migraine with brainstem aura is often more debilitating than migraine with typical aura due to aura intensity, the number of symptoms and longer length of attacks. Accurate diagnosis is essential, as effective treatment is usually a bit different from other migraine types, and prevention of attacks is essential regardless of how often you get them.

Read more about migraine with brainstem aura from The Migraine Trust, the American Migraine Foundation, or the US Genetic and Rare Disease Information Centre

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