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Basilar artery migraines

Migraine with brainstem aura, Bickerstaff migraine, Brainstem migraine, Vertebrobasilar migraine, Basilar migraine, Basilar-type migraine, MBA

Overview

A rare condition characterized by headache associated with a variety of neurological symptoms. The condition is caused by a disturbance of the basilar artery which is located in the brainstem.

It is a type of migraine headache with aura that is associated with pain at the back of the head on both sides. An aura is a group of symptoms that generally serve as a warning sign that a bad headache is coming. Auras may consist of dizziness and vertigo, slurred speech, ataxia, tinnitus, visual changes, and/or loss of balance. Although MBA can occur in men and women of all ages, they are most common in adolescent girls.[1][2]

Treatment during an episode may include nonsteroidal anti-inflammatory drugs (NSAIDs) and antiemetic medications to help ease the symptoms.[2]

Symptoms - Basilar artery migraines

  • Dizziness and vertigo
  • Disorientation
  • Double vision and other visual changes
  • Tinnitus
  • Loss of balance
  • Confusion
  • Dysarthria
  • Fainting
  • Loss of consciousnes
  • Headache
  • Poor muscular coordination
  • Vertigo
  • Ringing in the ears
  • Problems in hearing
  • Prickly feeling in the body
  • Sensitivity to light and sound
  • Jerky eye movements
  • Slurred speech
  • Problems in thinking clearly

Causes - Basilar artery migraines

The cause of migraine is unknown or is poorly understood. The condition may result from a series of reactions in the central nervous system caused by changes in the body or in the environment. There is often a family history of the disorder, suggesting that migraine sufferers may inherit sensitivity to triggers that produce inflammation in the blood vessels and nerves around the brain and scalp, causing pain.

Migraines are likely complex disorders that are influenced by multiple genes, in combination with lifestyle and environmental factors. In rare cases, susceptibility to MBA may be caused by a change (mutation) in the ATP1A2 gene or CACNA1A gene. In these cases, episodes may occur in more than one family member.

MBA, like all types of migraines, are likely complex disorders that are influenced by multiple genes in combination with lifestyle and environmental factors. Scientists also suspect that nerve abnormalities and/or altered blood flow to certain parts of the brain (brainstem and occipital lobes, specifically) may play a role in the development of MBA.

In most cases, migraines with brainstem aura (MBA) are not inherited. However, in rare cases, susceptibility to MBA may be caused by a change (mutation) in the ATP1A2 gene or CACNA1A gene. In these cases, an increased risk for MBA is inherited in an autosomal dominant manner. This means that to be affected, a person only needs a mutation in one copy of the responsible gene in each cell. In some cases, an affected person inherits the mutation from an affected parent. Other cases may result from new (de novo) mutations in the gene. These cases occur in people with no history of the disorder in their family. A person with one of these mutations has a 50% chance with each pregnancy of passing along the altered gene to his or her child.

Prevention - Basilar artery migraines

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Diagnosis - Basilar artery migraines

A diagnosis of migraine with brainstem aura (MBA) is made based on the presence of characteristic signs and symptoms. Although there are no tests available to confirm the diagnosis, additional testing may be ordered to rule out other conditions that can cause similar symptoms. These tests may include:

  • Brain MRI
  • MR angiogram (MRA)
  • Electroencephalogram
  • 24-hour heart monitor
  • Specialized blood tests

Prognosis - Basilar artery migraines

Not supplied.

Treatment - Basilar artery migraines

During an episode of migraine with brainstem aura (MBA), people are usually treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and antiemetic medications to help ease the symptoms. In some cases, a nerve block can be used to treat pain if other therapies are not working. In people with episodes that are frequent, prolonged, or particularly debilitating, medications such as verapamil or topiramate may be prescribed as a preventative therapy.

A host of treatments are available for treating Basilar Artery Migraine including Tri-cyclic antidepressents like amitriptylene, beta-blockers such as propranolol, calcium channel blockers, and anti-convulsants like depakote among others.

Resources - Basilar artery migraines

  • NIH
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