What is a basilar migraine?

A basilar migraine refers to a type of migraine with that begins in your brain stem. It’s sometimes called a Bickerstaff migraine or a basilar artery migraine.

The cause is unknown, but these migraines may be the result of a blood vessel that’s become tightened. This is called vasoconstriction, and it’s often caused by the muscles around your arteries becoming too tight and blocking blood flow.

Other possible causes are tortuous blood vessels, which have repeated twists and turns, and certain conditions that make it difficult for your brain to get enough blood.

Basilar migraines are considered a type of migraine with aura. This means the migraine can have symptoms that affect your senses, especially your sight. With this kind of migraine, you might see spots or lines in your vision as well as abnormal flashes of lights. During these disturbances or soon after, you get a bad headache.

Because this type of migraine starts in your brain stem, you may also have some symptoms on one side or both sides of your body.

Basilar migraines are relatively rare. They usually last for only an hour or so. Severe basilar migraines may last for a few hours, but they’re not usually a result of any serious condition. With treatment and an understanding of what can cause them, they can be managed without interrupting your daily life.

With this kind of migraine, you’ll likely experience many of the common symptoms of migraine with aura, such as:

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

Some symptoms that are specific to a basilar migraine include:

  • feeling nauseous
  • feeling extremely dizzy or as though your surroundings are spinning, to the point where you may not be able to stand up straight (known as vertigo)
  • having double vision (not able to focus your eyes or seeing two of everything)
  • feeling confused or disoriented
  • not being able to speak or pronounce words properly (slurred speech)
  • changes in your ability to hear (such as hearing ringing in your ears, which is called tinnitus)
  • having an extremely painful headache
  • not being able to control your muscles (known as ataxia)
  • blacking out and losing consciousness

If you have one or more of these symptoms, see your doctor as soon as possible.

Migraines don’t always have a traceable cause, so treating the underlying causes of a migraine can be difficult. Treating the symptoms of basilar migraines is the most effective way of relieving the pain and discomfort that goes along with having a migraine.


Some common medications to reduce basilar migraine symptoms (as well as those of other migraines with aura) include:

  • nonsteroidal anti-inflammatory drugs (NSAIDs) for relieving headache pain, such as ibuprofen (Advil)
  • antinausea medications, such as metoclopramide (Reglan)

Diet and lifestyle changes

Lifestyle changes can also help treat migraines, including the following:

  • Sleeping regularly for six to eight hours per night can help you get the amount of sleep you need to stop frequent migraines.
  • Allowing yourself to take a break and relax when you feel migraine symptoms coming on can help keep your migraine from getting worse after it starts.
  • When you first notice symptoms of a migraine, stop what you’re doing, try to stay in a dark room with minimal interruption, and put an ice pack on the back of your neck. This may help keep severe symptoms from occurring.
  • If food or drinks, especially those containing caffeine or alcohol, seem to trigger your migraines, eat and drink less of these trigger foods and beverages. Or stop having them altogether.

Basilar migraines are thought to be caused by arteries in your brain and neck being squeezed. Constriction of the basilar artery, an artery that goes through your neck and brain stem to bring blood up to your brain, is thought to be involved in causing basilar migraines. It’s not clear whether this is actually the case, though.

As with other migraines with aura, basilar migraines can be caused by a number of external factors, too. The most common causes of basilar migraines include:

  • stress, both physical and emotional
  • motion sickness
  • bright or flashing lights around you
  • strong smells
  • sudden changes in weather or air pressure (such as when you go to high altitudes)
  • certain medications, such as for birth control or blood pressure
  • certain foods and beverages, such as those containing caffeine or alcohol

Less common causes of basilar migraines include:

  • not getting enough sleep, or even getting too much sleep
  • being on your menstrual period if you’re a woman
  • being overweight or obese
  • overusing headache or migraine medication, which can give you “rebound” headaches
  • experiencing an epilepsy seizure

Taking certain medications can reduce the frequency and severity of your migraines. Common treatments for basilar migraines include:

  • medications that lower your blood pressure, such as beta-blockers and calcium channel blockers
  • medications to reduce seizures
  • medications to treat depression
  • injections of botox every three months or so
  • CGRP antagonists, a new class of drugs approved to prevent migraines

These medications can have some side effects and may interact with existing medications or with your diet. Talk to your doctor about which medication may work best for you before choosing any of them to help prevent migraines.

Some migraine medications such as triptans may not help prevent basilar migraines because they constrict your brain’s blood vessels. Talk to your doctor about whether these medications will work for you.

Basilar migraines are common in teenagers and young adults. According to the Genetic and Rare Disease Information Center, these kinds of migraines are most common in adolescent women.

Living in environments with sensory triggers can increase your risk, too. If smells, recurrent weather changes, bright lights, or stress trigger your migraines, you may want to consider moving to a location where you won’t encounter your triggers frequently or at all.

Basilar migraines can often be treated at home with over-the-counter medications, rest, and diet and lifestyle changes.

But if your symptoms are causing you to be unable to do daily tasks or if migraines have caused you to pass out, see your doctor right away or go to a nearby emergency room for treatment. This way, you can find out whether your symptoms are being caused by a more serious condition.