Basilar-Type Migraine
Key Points:
A migraine-type defined by the presence of migraine headache with neurological symptoms which begin either in the base of the brain or from both sides of the brain at the same time; i.e. brainstem or both cerebral hemispheres.
Many compare this migraine type more to hemiplegic migraine (migraine type with weakness) than to migraine with typical aura (99% visual symptoms). Those with less understanding of this headache consider it as "atypical or complicated" aura.
All patients describe visual symptoms, nearly 2 of 3 sensory and least often language or aphasic aura. Vertigo is the most frequent symptom type.
In actuality, nearly all basilar-type migraineurs suffer typical migraine with aura as well; just more frequent sensory and speaking difficulties of longer duration and intensity.
Obtain a correct diagnosis, optimal treatment plan, and prevent as many headaches as possible to reduce disability and improve prognosis.
http://www.achenet.org/resources/basilartype_migraine/
https://migraine.com/blog/migraine-triggers-and-comorbidities-dystonia/
The key to understanding this is the vertigo. This is a peripheral disorder of the inner ear. When neurologists think they have a case of vertigo due to a localised brain lesion, they publish it as a case report since these are so rare. Proven peripheral disorders of vestibular system are much commoner in migraine if an aura is also present. The simple explanation for this is that the sensory disorders in aurae, including the visual ones, are reflexly triggered from dysfunctional vestibular receptors.
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