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While there are many types of headaches that range in severity, migraines are known to be the most intense. One such type is the basilar migraine, which starts in the lower part of the brain, specifically, the brainstem. This condition can cause symptoms such as dizziness, double vision, slurred speech, and a general lack of coordination.

It can be so intense that it can affect a person’s vision causing visual disturbances. While researchers cannot say for sure what causes these migraines, there are treatments available to help prevent them, as well as lessen their intensity.

The focus of this article is to help you understand more about this condition. We will take you through every aspect, including what it is, its main causes, symptoms, and treatments.

What Is A Basilar Migraine?

A basilar migraine refers to a specific type of migraine that starts in the brainstem. Other names for this condition include ‘Bickerstaff migraine’ and ‘basilar artery migraine’.

While the exact cause of them is still unknown, this condition may be a result of blood vessels that have tightened. This is known as vasoconstriction, which is often caused by the muscles around the arteries becoming too tight and restricting blood flow. Other possible causes may include tortuous blood vessels, which have undergone certain changes that make it difficult for your brain to get adequate blood flow.

Furthermore, this kind of headache is considered a ‘migraine with brainstem aura’. This means that it can have symptoms that may affect your senses, most specifically your sight. Seeing as a basilar artery migraine starts in your brainstem, you may experience symptoms on either one side of the body, like a hemiplegic migraine, or on both sides.

A basilar migraine is generally quite a rare occurrence and usually lasts for an hour or so. More severe cases may last a few hours.

What is most important to know is that with the necessary knowledge combined with the correct treatment, you can manage these basilar artery migraines without interrupting your day to day life.

Main Causes Of Basilar Migraines

These basilar migraines are thought to be caused by arteries in your neck and brain being squeezed. The constriction of the basilar artery (the artery that goes through your neck and brain stem to ensure blood reaches your brain) is believed to be involved in causing this condition.

As with other conditions involving a migraine with brainstem aura, a basilar-type migraine can also be caused by a variety of external factors that include, but are not limited to, the following:

  • Immense stress (physical or emotional)
  • Bright lights flashing around you
  • Motion sickness
  • Potent smells
  • Certain medications or hormonal contraceptive pills (such as birth control)
  • Sudden changes in air pressure or weather (especially when you are in higher altitudes)
  • Certain food or beverages (more commonly those containing alcohol or caffeine)
  • Certain blood pressure medications
  • Hormone fluctuations in women
  • Epilepsy or fits
  • Being overweight
  • Nitrites in food
  • Overuse of headache medications

What Are The Symptoms of Basilar Migraines?

If you suffer from a basilar-type migraine, you will likely experience some of the following common symptoms of a migraine with aura:

  • seeing flashing lights in your vision, with no external source
  • seeing “static” or losing full vision
  • seeing stars, spots, or lines in your vision
  • feeling numb in your face, head, or hands
  • feeling exceedingly weak or exhausted

However, some migraine symptoms are more specific to this condition. These include:

  • Extremely painful headache
  • Nausea
  • Extreme dizziness (you may not be able to stand up straight, also known as vertigo)
  • Confusion or disorientation
  • Double vision (preventing you from focusing your eyes and potentially resulting in you seeing double)
  • Slurred speech/inability to pronounce words properly
  • Ringing in your ears (also known as tinnitus)
  • Inability to control muscles (also known as ataxia)
  • Blacking out or losing consciousness

If you have any of the above symptoms it is recommended that you see a doctor as soon as possible and seek medical advice before it gets worse.

Are Basilar Artery Migraines Preventable?

There are a few lifestyle changes that could help reduce the risk of experiencing a basilar-type migraine with brainstem aura. These include, but are not limited to:

  • Avoiding triggers by seeing a doctor to try to identify said triggers and create a plan to avoid them.
  • Regular exercise has been proven to reduce the frequency and severity of the headaches. Exercise also releases endorphins and hormones that can act as natural painkillers in your body.
  • Maintain a balanced diet by eating small meals throughout the day ensuring consistent energy. Ideally, these meals should include foods that contain the right combination of carbohydrates, fats, protein, vitamins, and minerals.
  • Get enough sleep! Establishing a quiet, peaceful sleep environment is vital. Developing a consistent sleep regiment will help you get the rest you need to avoid migraines.

How To Treat A Basilar Migraine

Medication is the most popular treatment for a basilar brainstem migraine and can sometimes provide the only short-term pain relief available. Medication can also help prevent these basilar artery migraines from becoming a recurring condition.

Since headaches don’t always have an exact traceable cause, treating the underlying causes can sometimes be a bit difficult. By treating the main symptoms of the headache, you will be able to relieve some of the pain and discomfort.

The following treatments may help you manage a basilar migraine with brainstem aura:


There are some medications that can help reduce basilar migraine symptoms.

Nonsteroidal anti-inflammatory drugs and naproxen sodium are both available over the counter. Research shows that NSAIDs can sometimes help patients to treat certain mild to moderate basilar migraine with aura symptoms.

Antiemetics are usually used to treat motion sickness. However, research shows that these drugs can help address nausea and vomiting during basilar migraine attacks.

Occipital nerve blocks (ONBs) can also be used to treat a migraine with brainstem aura, but involve the use of an injectable solution. This solution will deliver immediate results, generally offering pain relief within 1 minute of injecting the patient.

Some other medical treatments can include:

  • Medications that lower your blood pressure (such as calcium channel blockers and beta-blockers)
  • Medication used to reduce seizures or treat depression
  • In certain cases, botox injections can be useful if administered approximately every three months
  • Triptans, which can help regulate serotonin levels
  • Ergotamine

Lifestyle & Diet Change

Lifestyle changes may also help prevent the occurrence of a migraine with brainstem aura. These include:

  • Sleeping for 6-8 hours every night
  • Allowing yourself to relax or take a break when your migraine with aura symptoms are getting worse
  • When you notice symptoms coming on, try to stay in a quiet, dark room with an ice pack on the back of your neck
  • Avoid drinks with alcohol or caffeine
  • Eating a well-balanced diet
  • Not skipping meals
  • Avoid trigger foods

Certain foods may also trigger a basilar migraine attack so avoiding them could help prevent the frequency of your headaches. Some trigger foods include:

  • Wheat
  • Dairy
  • Chocolate
  • Eggs
  • Oranges
  • Tomatoes
  • Rye

Natural Treatments

For those who prefer a more holistic approach, there are many natural ways to help prevent and manage this condition. It is important to remember that when it comes to natural remedies, what works for one may not work for another. Holistic remedies include, but are not limited to:

  • Magnesium These can help reduce the frequency of headaches, especially in people who suffer from magnesium deficiency.
  • Lavender or peppermint essential oils can help soothe and calm your mind and can act as a sedative to relieve your stress and anxiety. Inhaling lavender can help decrease your headache symptoms within as little as 15 minutes. While peppermint oil is known to help you breathe easier.

By making these changes, you can certainly help reduce your chances of experiencing intense headaches of this kind. However, if you have made all these changes and still don’t seem to be responding positively, it may be time to seek the help of a trained specialist.

If you have 4 or more migraine-with-aura days in one month, you should consult a medical professional about preventive medication. Either way, it is recommended to see a doctor as soon as your headaches start to intensify in order to pin-point the exact triggers and start your treatment.

Since these medications can have certain side-effects or simply may not work on your specific case, it is crucial to talk to your doctor before starting any new medication.


A basilar migraine condition is very rare and should not be taken lightly. If you feel like you may be suffering from a migraine with brainstem aura, it is imperative to get seen by a doctor to get your diagnosis and treatment plan.

It is also recommended that people who have suffered from this condition for a long time should journal their experiences before visiting the doctor. This way, you will have all the relevant information about your symptoms and possible trigger correlations.

When visiting your doctor there are a few key questions you should ask:

  • What are the main triggers and how do I determine my triggers?
  • What are my treatment options?
  • What are the side effects of the medication prescribed?
  • What symptoms are considered normal?
  • What abnormal symptoms should I keep an eye out for? I.e. What constitutes an emergency?

While it is hard to pinpoint the exact characteristics of this condition, there is a wide variety of resources available to you online. Most importantly, we highly recommend that you don’t wait for your headaches to reach their breaking point before seeking medical help.