National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Migraine with brainstem aura


Other Names:
Bickerstaff migraine; Basilar artery migraine; Brainstem migraine; Bickerstaff migraine; Basilar artery migraine; Brainstem migraine; Vertebrobasilar migraine; Basilar migraine; Basilar-type migraine; MBA See More
Categories:
Migraine with brainstem aura (MBA) 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] The exact underlying cause of MBA is poorly understood. Migraines are likely complex disorders that are influenced by multiple genes, in combination with lifestyle and environmental factors.[3] In rare cases, susceptibility to MBA may be caused by a change (mutation) in the ATP1A2 gene or CACNA1A gene.[4][5] Treatment during an episode may include nonsteroidal anti-inflammatory drugs (NSAIDs) and antiemetic medications to help ease the symptoms.[2]
Last updated: 6/15/2016
Episodes of migraine with brainstem aura (MBA) usually begin with an aura, which is a group of symptoms that serve as a warning sign that a bad headache is coming. Signs and symptoms of an aura vary, but may include:[1][2][6]
  • Dizziness and vertigo
  • Disorientation
  • Double vision and other visual changes
  • Tinnitus
  • Loss of balance
  • Confusion
  • Dysarthria
  • Fainting
  • Loss of consciousness
These symptoms can last any where from two minutes to over an hour. They are then followed by a throbbing headache which is often along the back of the head, and nausea.[2]
Last updated: 2/19/2015

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

Showing of 20 |
Medical Terms Other Names
Learn More:
HPO ID
Percent of people who have these symptoms is not available through HPO
Aphasia
Difficulty finding words
Losing words
Loss of words
[ more ] 		0002381
Apraxia 0002186
Autosomal dominant inheritance 0000006
Blurred vision 0000622
Coma 0001259
Confusion
Disorientation
Easily confused
Mental disorientation
[ more ] 		0001289
Diplopia
Double vision
0000651
Drowsiness
Sleepy
0002329
Dysarthria
Difficulty articulating speech
0001260
Dysphasia 0002357
Episodic ataxia 0002131
Fever 0001945
Hemiparesis
Weakness of one side of body
0001269
Hemiplegia
Paralysis on one side of body
0002301
Incomplete penetrance 0003829
Intellectual disability
Mental deficiency
Mental retardation
Mental retardation, nonspecific
Mental-retardation
[ more ] 		0001249
Migraine with aura 0002077
Seizure 0001250
Transient unilateral blurring of vision 0001125
Vertigo
Dizzy spell
0002321
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Last updated: 7/1/2020
The exact underlying cause of migraine with brainstem aura (MBA) is not well understood. MBA, like all types of migraines, are likely complex disorders that are influenced by multiple genes in combination with lifestyle and environmental factors.[3] 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.[2]

Susceptibility to MBA may rarely 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.[4][5]
Last updated: 6/15/2016
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.[4][5] 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.
Last updated: 2/19/2015
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:[2]
Last updated: 2/19/2015
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.[2]
Last updated: 2/19/2015
Due to the rarity of these migraines, there is limited data on the long-term outlook (prognosis) for affected people. Although the symptoms are often severe during episodes, they generally resolve on their own with no lasting complications. Some research suggests that the frequency of MBA decreases with age, although they may evolve into episodes of more typical forms of migraines in some affected people. Migraines with aura do carry a small risk of migrainous infarction (stroke in the setting of a migraine attack) and ischemic stroke.[2]
Last updated: 2/19/2015

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • ClinicalTrials.gov lists trials that are related to Migraine with brainstem aura. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

    Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
  • The National Institute of Neurological Disorders and Stroke (NINDS) collects and disseminates research information related to neurological disorders. Click on the link to view information on this topic.

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Migraine with brainstem aura. Click on the link to view a sample search on this topic.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question

  • I am a 50 year old woman who has recently been diagnosed with basilar artery migraines with the aura. I've never had migraines before. How rare is it to manifest at this late age? See answer

  • My daughter was diagnosed basilar migraine several months ago. I feel she could also have POTS. Can the two conditions co-exist? See answer


  1. Rima M Dafer, MD, MPH, FAHA. Migraine Variants. Medscape Reference. March 2012; http://emedicine.medscape.com/article/1142731-overview#a1.
  2. David F Black, MD; Carrie Elizabeth Robertson, MD. Migraine with brainstem aura (basilar-type migraine). UpToDate. February 2015; Accessed 2/19/2015.
  3. Basilar-Type Migraine. American Headache Society. 2010; http://www.achenet.org/resources/basilartype_migraine/.
  4. Ambrosini A, D'Onofrio M, Grieco GS, Di Mambro A, Montagna G, Fortini D, Nicoletti F, Nappi G, Sances G, Schoenen J, Buzzi MG, Santorelli FM, Pierelli F. Familial basilar migraine associated with a new mutation in the ATP1A2 gene. Neurology. December 2005; 65(11):1826-1828.
  5. Robbins MS, Lipton RB, Laureta EC, Grosberg BM. CACNA1A nonsense mutation is associated with basilar-type migraine and episodic ataxia type 2. Headache. July 2009; 49(7):1042-1046.
  6. Headache: Hope Through Research. National Institute of Neurological Disorders and Stroke. February 2015; http://www.ninds.nih.gov/disorders/headache/detail_headache.htm.