Introduction:
In the past, migraine with brainstem aura was known as basilar-type migraine, basilar artery migraine, and basilar migraine. As it implies that the basilar artery is the source of the attack, the terms "basilar artery," "basilar-type," or "basilar" are misleading. Bickerstaff gave it the name basilar in 1961. He shared his beliefs that short-term spasms or narrowing of the basilar artery was the cause of his migraines with brainstem aura. For more than three decades, this belief remained a concern. Even worse, it prevented migraine sufferers with brainstem auras from participating in triptan clinical trials. The Federal Drug Administration (FDA) decided against prescribing triptans to migraine sufferers with brainstem aura due to their absence from trials.
Nowadays, it is understood that migraine is a common but intricate genetic disorder caused by environmental factors. Similar to other types of migraine, the brainstem aura is caused by nerves rather than vessels in migraine patients.
Bickerstaff suggested that female adolescents were more likely to suffer from migraine with brainstem aura; however, it is now known that migraine with brainstem aura affects people of all ages. However there is a predominance of female gender as migraine sufferer with brainstem auras, just like there is in migraines overall.
What Is a Migraine With a Brainstem Aura?
A type of migraine known as migraine with brainstem aura (MBA) involves symptoms like vertigo, difficulty speaking and hearing, and loss of muscle control that begin in the brainstem.
This kind of migraine has previously been referred to as basilar artery migraine or basilar migraine. It is now referred to as "migraine with brainstem aura" by the International Headache Society. Even though it has been known for half a century, this kind of migraine is still somewhat of a mystery. It is highly uncommon, and cause is a mystery, and its diagnosis and even existence are still in doubt.
The set of symptoms that come before a migraine attack is referred to as "aura" in medicine. A type of migraine with an aura is known as a migraine with a brainstem aura. This means that migraines can cause symptoms that make it hard to see or hear.
The person may experience erratic light flashes, spots, or lines in their vision as well as MBA. Headaches typically occur during or shortly after these disturbances, but not always.
Aura of a brainstem migraine is uncommon. According to recent research, they affect 0.4 percent of the general population, 1.6 percent of headache sufferers, and 10 percent of migraine sufferers with a visual aura.
Most of the time, this kind of migraine only lasts about an hour. Although severe MBAs may last for a few hours, they are rarely the result of a severe illness.
MBAs can be managed without interfering with day-to-day activities with treatment and an understanding of their potential causes.
What Causes Migraine With Brainstem Aura?
The exact causes of MBA are unknown. In some studies, the cause is linked to abnormal nerve activity, while in other studies, altered blood flow to the brainstem is suggested.
Additionally, genetic causes are being investigated by scientists. Most of the time, they do not think that migraines with a brainstem aura are inherited. MBAs may be brought on by a mutation or change in the ATP1A2 or CACNA1A genes.
Scientists agree that environmental and lifestyle factors can trigger this type of migraine attack, despite the fact that the exact causes of migraine with brainstem aura are unknown.
The most common causes of MBAs, according to research published in the journal Pain Medicine, are emotional situations (74 percent) followed by sleep disorders (65 percent).
Few other triggers include:
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Stress.
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Sunlight.
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Change in weather or altitude.
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Fatigue.
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Alcohol.
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Strong smells.
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Bright or flashing lights.
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Certain medications such as birth control or blood pressure.
What Are the Symptoms of Migraine With Brainstem Aura?
Migraine with brainstem aura is a type of migraine in which aura symptoms come from either both sides of the brain (cerebral hemispheres) or the brainstem. In addition to the typical aura symptoms, migraine sufferers with brainstem aura also experience the following:
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Visual (examples include moving or expanding sparkles or zigzag lights in the vision. Usually, only on one side of the field of vision).
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Sensory (for instance, numbness or tingling in one arm that extends to one side of the face).
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Symptoms of speech and language (for example, difficulty understanding what others are saying or difficulty producing words despite knowing what to say).
Each symptom can be completely reversed and typically only lasts for up to 60 minutes at a time. Motor (paralysis or weakness) or retinal (changes in the vision or loss in one eye only) symptoms should not be present.
Additionally, people who suffer from migraines with a brainstem aura experience symptoms like the following:
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Vertigo (the sensation of moving or being spun around oneself or the environment).
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Dysarthria (slurred speech).
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Tinnitus (ringing sensation in the ears).
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Ataxia (uncoordinated or unsteady movements).
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Hypacusis (decrease or partial loss of hearing).
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Diplopia (double vision).
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Decreased level of consciousness.
Many of these symptoms can be mistaken for anxiety or hyperventilation because they can occur together.
How Is Migraine With Brainstem Aura Diagnosed?
A thorough investigation into the underlying cause of migraines with a brainstem aura should be carried out by a doctor, including brain and the vessels in the head imaging. To rule out disorders of the seizure, an EEG (electroencephalogram) is frequently performed; especially when people's alert states change or become confused.
Additionally, the patient's primary headache disorder, which can mimic migraine with a brainstem aura, should be checked by the doctor. Hemiplegic migraine and migraine with a typical aura are two additional primary headache disorders that resemble migraine with a brainstem aura. It is absolutely necessary for the diagnosis to be accurate and definitive.
How Is Migraine With Brainstem Aura Treated?
Because migraines don't always have a clear cause, it can be hard to treat the underlying causes. The most efficient method for reducing pain and discomfort associated with a migraine attack is to treat the symptoms with a brainstem aura.
Medications for Acute Attacks:
Migraine prescription pills can be prescribed online at a telemedicine portal or at an in-office doctor's visit. The following are some common medications that can alleviate the symptoms of migraines with brainstem aura as well as other migraines with aura:
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NSAIDs or nonsteroidal anti-inflammatory drugs, such as Ibuprofen, are used to ease headache pain.
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CGRP (calcitonin gene related peptide receptor) antagonists in the form of small molecules like Rimegepant and Ubrogepant
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Antinausea medications such as Metoclopramide.
Diet and Lifestyle:
Changing one's lifestyle can also help treat migraines, such as the following:
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Sleeping six to eight hours each night is recommended. Sleeping this much may help prevent frequent migraine attacks.
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When symptoms of a migraine attack first appear, it's best to stay in a dark room without being disturbed and apply an ice pack to the back of the neck. The onset of severe symptoms may be prevented by these measures.
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Eating and drinking less of foods and beverages that trigger the migraine. It is recommended to reduce or completely eliminate the triggering foods and drinks once they have been identified.
Conclusion:
Over-the-counter medications, rest, and adjustments to diet and lifestyle are frequently all that is needed to treat migraine with brainstem aura at home. However, if the symptoms make it difficult to carry out day-to-day activities or if migraine attacks have rendered a person unconscious, it is best to seek immediate medical attention or to visit an ER in the area for treatment. It is possible for anyone to determine whether a migraine with a brainstem aura or a more serious condition is to blame for their symptoms. They can get help dealing with the migraine, which is a condition that can be upsetting but can be treated.
