Presentation
Literatures of migraineurs presented with coma were reviewed. The two patients are partially resolved with prophylactic propranolol or valproate therapy. BTM should be considered for any patient presenting with migraine and coma. [ncbi.nlm.nih.gov]
The signs and symptoms of neurological disease are elusive by their very nature, presenting a confounding diagnostic challenge. [books.google.com]
Entire Body System
- Fatigue
Intense emotional stimuli (74%) and sleep disorders (65%) were the most common trigger factors, followed by change in weather, sunshine, cold wind, acute stress, alcohol, and fatigue. [ncbi.nlm.nih.gov]
"It can be very fatiguing," Dr. Messina says. [health.com]
A 2014 study published in the journal Pain Medicine identified these as the ones most involved: Intense emotional situations Sleep disorders Weather Sunlight Cold wind Stress Alcohol Fatigue Diagnosis There are no specific tests for diagnosing migraine [verywell.com]
It is usually felt on one side of the head and is coupled with symptoms that can include nausea, blurred vision, fatigue, and a sensitivity to light, sounds, or smells. This type of migraine can last from four hours to several days. [reedmigraine.com]
The acute phase may be accompanied by nausea, vomiting, chills, polyuria, sweating, facial edema, irritability, and extreme fatigue. [medical-dictionary.thefreedictionary.com]
- Falling
These children continue to "fall through the cracks" of our medical education system. [books.google.com]
The cause of, or trigger to, menstrual migraine is thought to be the fall of the level of oestrogen that occurs at this time in the cycle. Oestrogen is one of the chemicals (hormones) that control the menstrual cycle. [patient.info]
The fall in the levels of estrogen is thought to trigger migraine headache 6. In a menstrual migraine, the onset of attack can be 2 days prior to periods or 2 days after periods begin. [mewithoutmigraine.com]
Advertisement 4 of 19 Getty Images Lack of restful sleep Waking up tired or having trouble falling asleep are common problems in people with migraines. [health.com]
I’m a chronic migraineur headaches and migraines are nothing new to me but last summer to autumn (fall) I started getting sharp pain in my head in one of two coin-sized regions Nearly everyone will suffer an occasional headache it’s almost inevitable. [emergingindustries.eu]
- Swelling
Feeling tired ; Headache ; Feeling cold ; Shaking chills ; Body aches ; Skin rashes ; Any new area of redness or swelling ; People suffering from TMJ syndrome ought to abide by a few ‘don’ts’. camelia hasn’t flowered. [bionexgen-fp7.eu]
There is usually tenderness and swelling over the carotid artery in the neck. Episodes can occur several times weekly and last a few minutes to hours. This type occurs more commonly in older people. [healthcommunities.com]
White onions cause severe mouth ulcers and swelling of the lips and leave nasty scabs and But raw or large amounts of cooked onions will give me a headache I’m a former cluster head! [emergingindustries.eu]
Altered mental status, including seizure Focal neurologic deficits Papilledema : an optic disc swelling that is secondary to elevated intracranial pressure. [11] Severe hypertension Medical Management (current best evidence) Medications According to Clinical [physio-pedia.com]
- Nightmare
Working on your balance is a nightmare – the exercises you have to do basically disturb your balance and make you feel sick, with the hope that you are retraining your brain to recalibrate properly. [migrainetrust.org]
Gastrointestinal
- Nausea
The headache that follows these effects may be severe and there is nausea and sometimes vomiting and great intolerance to light. [medical-dictionary.thefreedictionary.com]
Treatments for MBA generally aim to relieve symptoms of pain and nausea. You might take pain relievers such as acetaminophen, ibuprofen, and naproxen, as well as nausea medicines such as chlorpromazine, metoclopramide, and prochlorperazine. [webmd.com]
Although the typical symptoms like headache, nausea, weight loss, flushing, heart palpitation or paroxysmal hypertension during micturition are well established, we present an unusual case of bladder paraganglioma, 'misdiagnosed' with basilar-type migraine [ncbi.nlm.nih.gov]
Antiemetics (anti-nausea): Medications to treat nausea, such as phenothiazine, may be used to treat migraine with brainstem aura. [verywell.com]
Order Now no prescription necessary Published on: March 14, 2012 3:38 am Basilar-Type Migraine (BTM) headaches are not your average migraine headache- while many migraines with aura cause symptoms like dizziness, visual distortions, and nausea that can [migravent.com]
Skin
- Sweating
(with Green Tea to escort herbs up): headache nasal congestion Formula: Ge Gen Tang: fever and chills no sweating stiff neck and back cannot move the head Touch of Sun Products Enters through the nose and mouth Fever Sweating Sore throat Headache Irritability [emergingindustries.eu]
Sweating. Scalp tenderness. Sensations of heat or cold. Migraine with aura This is less common than migraine without aura. [patient.info]
The acute phase may be accompanied by nausea, vomiting, chills, polyuria, sweating, facial edema, irritability, and extreme fatigue. [medical-dictionary.thefreedictionary.com]
Sensitivity to light, noise and odors Nausea and vomiting, stomach upset, abdominal pain Loss of appetite Feeling very warm (sweating) or cold (chills) Pale color (pallor) Feeling tired Dizziness Blurred vision Tender scalp Diarrhea (rare) Fever (rare [my.clevelandclinic.org]
As cold sweat headache chest pain head back tension left long as there have been migraines there have been people desperate for relief. When menstrual bleeding is abundant plasmin might not be enough and some blood clots may form. [bionexgen-fp7.eu]
- Skin Rash
Feeling tired ; Headache ; Feeling cold ; Shaking chills ; Body aches ; Skin rashes ; Any new area of redness or swelling ; People suffering from TMJ syndrome ought to abide by a few ‘don’ts’. camelia hasn’t flowered. [bionexgen-fp7.eu]
Eyes
- Diplopia
The basilar-type aura had a median duration of 60 minutes and comprised vertigo 61%, dysarthria 53%, tinnitus 45%, diplopia 45%, bilateral visual symptoms 40%, bilateral paresthesias 24%, decreased level of consciousness 21%, hypacusia 21%, and ataxia [ncbi.nlm.nih.gov]
The symptoms can last from 5 to 60 minutes and may include ataxia, vertigo, diplopia, bitemporal or binasal visual field loss, dysarthria, tinnitus, hyperacusia, bilateral sensory changes and alterations in consciousness, but no motor weakness in peripheral [link.springer.com]
Diplopia does not embrace (or exclude) blurred vision. The Glasgow Coma Scale (GCS) score may have been assessed during admission; alternatively, deficits clearly described by the patient allow GCS estimation. [ichd-3.org]
Features of the aura may include: vertigo dysarthria ataxia diplopia bilateral visual impairment or sensory symptoms The proceeding headache is usually occipital. [gpnotebook.co.uk]
- Scotoma
[…] phenomenon, e.g., scintillating scotomas. migraine, n See headache, migraine. [medical-dictionary.thefreedictionary.com]
Most auras are visual and are described as bright shimmering lights around objects or at the edges of the field of vision (called scintillating scotomas) or zigzag lines, castles (teichopsia), wavy images or hallucinations. [healthcommunities.com]
During this stage, about one-third of patients see flashing lights, wavy lines and blank spots in their field of vision (called scotoma) for a few minutes to a few hours before the pain stage begins. [migrelief.com]
[…] whirled round with dizziness, and the ears ring as from the sound of rivers rolling along with a great noise, or like the wind when it roars among the sails, or like the clang of pipes or reeds, or like the rattling of a carriage, we call the affection scotoma [medlink.com]
편두통의 전조증상으로 나타나는 시환각(Fortification spectra) 전조로 나타나는 시환각의 일종인 시야 암점 (scotoma) 편두통성 현훈 증후군(MAV syndromes) 전조가 없는 편두통(약 80%)과 전조를 동반하는 편두통(약 15-20%)이 가장 흔한 편두통의 형태이며, 또한 편두통성 현훈증을 나타내는 가장 흔한 질환이다. [dizziness-and-balance.com]
- Visual Impairment
Features of the aura may include: vertigo dysarthria ataxia diplopia bilateral visual impairment or sensory symptoms The proceeding headache is usually occipital. [gpnotebook.co.uk]
This phase may last between five minutes to an hour, and it may cause patients to experience the following: Vertigo Visual impairment to the point of blindness Double vision Numbness of extremities Near-loss of consciousness Since the symptoms above are [blog.themigrainereliefcenter.com]
- Photopsia
Most patients also have typical aura symptoms like photopsia, loss of vision, paresthesia, speech, and language problems like word-finding difficulty, language comprehension, and difficulty reading. [ncbi.nlm.nih.gov]
Ears
- Tinnitus
The basilar-type aura had a median duration of 60 minutes and comprised vertigo 61%, dysarthria 53%, tinnitus 45%, diplopia 45%, bilateral visual symptoms 40%, bilateral paresthesias 24%, decreased level of consciousness 21%, hypacusia 21%, and ataxia [ncbi.nlm.nih.gov]
Symptoms include partial or total loss of vision or double vision, dizziness and loss of balance (vertigo), poor muscle coordination, slurred speech, a ringing in the ears (tinnitus), and fainting. [medium.com]
The symptoms can last from 5 to 60 minutes and may include ataxia, vertigo, diplopia, bitemporal or binasal visual field loss, dysarthria, tinnitus, hyperacusia, bilateral sensory changes and alterations in consciousness, but no motor weakness in peripheral [link.springer.com]
Tinnitus E. Decreased hearing F. Double vision G. Ataxia H. Bilateral paresthesias I. Bilateral paresis J. [dynamicchiropractic.com]
- Hearing Problem
Aura most commonly consists of a spinning sensation (vertigo), noise in the ears (tinnitus), double vision (diplopia), hearing problems (hypacusia), poor limb coordination (ataxia), and unpleasant sensations in the face arms or legs (ranging from prickling [migrainerelief.com]
Vertigo – 73% Lack of muscle coordination – 40-50% Nausea – 30-50% Problems with vision – 30-45% Confusion – 20% Weakness – 20% Hearing problems – 10-15% Causes of Basilar-type Migraine The causes of basilar migraines are yet to be fully understood, however [migrainemagazine.com]
problems The head pain experienced with basilar type migraine occurs at the base of the head. [whentaniatalks.com]
The symptoms will include two or more of the following : visual disturbances in both eyes speaking difficulties hearing problems tingling in the hands and feet dizziness vertigo ringing in the ears. [migrainetrust.org]
Visual problems. Hearing problems. Difficulty speaking or swallowing. Important note : see a doctor urgently if you get sudden weakness (particularly if it occurs for the first time). [patient.info]
- Hyperacusis
Other symptoms such as diplopia, visual symptoms, dysarthria, hyperacusis, ataxia, decreased level of consciousness, and bilateral (simultaneous) paresthesias and tinnitus may also be noted. [prognosisapp.com]
Sensory amplification is very common -- Hyperacusis is common in migraine, which may differentiate it from most ear disorders. Sensitivity to light (photophobia) is also commonly present. [dizziness-and-balance.com]
- Hearing Impairment
However, no definitive genetic linkage is identified.[5][6][6] History and Physical Brainstem aura symptoms include vertigo, dysarthria, diplopia, tinnitus, impaired hearing, lack of coordination, confusion, and sometimes loss of consciousness. [ncbi.nlm.nih.gov]
- Sudden Hearing Loss
Virre and Baloh (1996) suggested that sudden hearing loss may also be caused by migraine. Hearing loss in migraine rarely progresses (Battista, 2004). [dizziness-and-balance.com]
Psychiatrical
- Fear
Fear of getting stranded somewhere because it’s not safe for me to drive during an attack. Having to leave a job I love and take disability because I could not consistently show up for work. 12. [thedailyheadache.com]
Neurologic
- Headache
All consecutive patients citing headache as their chief complaint were asked to complete a face-to-face interview by a qualified headache specialist using a detailed questionnaire for headache. [ncbi.nlm.nih.gov]
The author discusses all common headache conditions: migraine, chronic migraine, status migraine, cluster and related headaches, tension headaches, sinus headaches, cervicogenic headaches, secondary headaches, and neuralgias. [books.google.com]
Primary headaches are idiopathic headache disorders where the causes of headaches are not clear such The headaches develop gradually last longer and are more debilitating than the migraine with aura. [emergingindustries.eu]
- Vertigo
CONCLUSION: The relationship between BtM, dMV, and pMV refers to a distribution of severity across the disease spectrum of migraine-related vertigo. [ncbi.nlm.nih.gov]
[…] benign paroxysmal positional vertigo (in which patients experience brief episodes of vertigo, lasting from seconds to 1 minute, when they move their heads in a certain way). [books.google.com]
Familial migraine with vertigo and essential tremor. Neurology 1996l46(2), 458-60 Basser LS. Benign paroxysmal vertigo of childhood: a variety of vestibular neuronitis. [dizziness-and-balance.com]
In the 1960s, neurologist Edwin Bickerstaff theorized about spasms occurring in the basilar artery, thus provoking a particular migraine attack that could bring about strong vertigo and temporary blindness. [blog.themigrainereliefcenter.com]
- Dizziness
This book provides a multidisciplinary approach to vestibular migraine and related syndromes in which dizziness is the most predominant feature. [books.google.com]
Some basilar migraine sufferers experience dizziness or problems with muscle coordination after the migraine attack. [migraine.com]
It is also common for sufferers to experience problems after the migraine attack such as difficulty coordinating muscles or dizziness. [migrainemagazine.com]
At first glance, somebody suffering from a BTM aura may appear to be intoxicated, as slurred speech, dizziness, and walking difficulties are common symptoms. [migravent.com]
The figure above shows the distribution of migraine with dizziness in a subset of patients from the dizziness practice of the author. [dizziness-and-balance.com]
- Ataxia
Mutations in the CACNA1A gene on chromosome 19 have been associated with a variety of clinical disorders, including familial hemiplegic migraine type 1 and episodic ataxia type 2 (EA2). [ncbi.nlm.nih.gov]
The symptoms can last from 5 to 60 minutes and may include ataxia, vertigo, diplopia, bitemporal or binasal visual field loss, dysarthria, tinnitus, hyperacusia, bilateral sensory changes and alterations in consciousness, but no motor weakness in peripheral [link.springer.com]
Ataxia H. Bilateral paresthesias I. Bilateral paresis J. [dynamicchiropractic.com]
- Confusion
The symptoms can be confused with other serious conditions, for one thing, so your doctor may call for more tests than would be normal with migraine. Also, there’s concern that those with BTM may have a greatly increased chance of stroke. [headacheandmigrainenews.com]
Percentage of people with basilar migraines who have each migraine symptom Vertigo, 73 percent Ataxia, lack of muscle coordination or unsteadiness, 43-50 percent Nausea or vomiting, 30-50 percent Vision changes, 43 percent Double vision, 30 percent Confusion [migraine.com]
Vertigo – 73% Lack of muscle coordination – 40-50% Nausea – 30-50% Problems with vision – 30-45% Confusion – 20% Weakness – 20% Hearing problems – 10-15% Causes of Basilar-type Migraine The causes of basilar migraines are yet to be fully understood, however [migrainemagazine.com]
Prodromal symptoms of migraine-like mood swings, irritability, tiredness, nausea, and neck pain should not be confused with aura symptoms. [ncbi.nlm.nih.gov]
Double vision Blurred vision Temporary blindness Aphasic aura (slurred speech) Difficulty controlling your tongue, jaw, or throat muscles Ataxia (loss of balance while walking) Paresthesias (numbness or “pins and needles” in the face, hands, or feet) Confusion [migravent.com]
Workup
As urologists linked the presence of a tumor (by CT) and symptoms connected with micturition, no cystoscopy and no transurethral resection of the bladder was performed prior to detailed diagnostic workup. [ncbi.nlm.nih.gov]
Gastroenterologic evaluation and workup typically yield unremarkable results. [48] Abdominal migraine symptoms are usually relieved with sleep. Antiemetics may help in aborting an acute attack. [emedicine.medscape.com]
Treatment
At that time, proven treatment options for BM are rather limited and lamotrigine has been tested in BM patients because it was a widely tested treatment for migraine with aura. [ncbi.nlm.nih.gov]
The first chapter stresses the etiology and pathophysiology of childhood stroke as the basis for evaluations and treatment. [books.google.com]
Ultimately, complementary therapies are generally less likely to produce harmful side effects, despite questions of effectiveness, so do consider a treatment plan that utilizes the best of both drug treatment and holistic techniques. [headacheexpert.co.uk]
Traci Purath help you regain your life with superior migraine headache treatments. Contact best migraine headache neurologist, Dr. Traci Purath providing superior treatment for basilar migraine sufferers [drtracipurath.com]
Prognosis
Disability and Prognosis As with other forms of Migraine, BTM can be disabling. [healthcentral.com]
Disability and Prognosis As with other forms of migraine, migraine with brainstem aura can be disabling. [americanmigrainefoundation.org]
[…] that should be excluded before a clinician makes a definite diagnosis of a basilar migraine include Meniere disease, vestibular disease, transient ischemic attack (TIA), stroke, brainstem atrioventricular (AV) malformation, tumors, and meningitis.[7] Prognosis [ncbi.nlm.nih.gov]
[…] 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 [rarediseases.info.nih.gov]
[…] basal ganglia or basal nuclei are large masses of grey matter located within the central core of white matter of the cerebral hemispheres.The basal ganglia is composed of the following grey nuclei Basal Ganglia Stroke - Symptoms, Treatment, Recovery, Prognosis [mannens.fun]
Etiology
The first chapter stresses the etiology and pathophysiology of childhood stroke as the basis for evaluations and treatment. [books.google.com]
Migraine with brainstem aura (a basilar migraine) is a rare subtype of a migraine with aura that presents with symptoms originating from the brainstem or both cerebral hemispheres at the same time.[1][2][3][4] Etiology The exact etiology of migraine with [ncbi.nlm.nih.gov]
Migraine with aura symptoms clearly originate from the brainstem and are not ischemic in etiology. Because involvement of the basilar artery is unlikely, the term migraine with brainstem aura is preferred. [medlink.com]
Additionally, gastroparesis, which occurs during migraine, has been implicated as an etiologic factor for cyclic vomiting and abdominal migraine. [51, 52, 53] A serum lactate level is helpful in these children to exclude mitochondrial disorders. [emedicine.medscape.com]
Epidemiology
There is no firm clinical, epidemiologic, or genetic evidence that BM is an independent disease entity different from MTA. [ncbi.nlm.nih.gov]
Hemiplegic and basilar-type migraine: Epidemiology, genetics, and mechanisms. Headache Currents, 3 (4), 73–81. doi:10.1111/j.1743-5013.2006.00036.x [repub.eur.nl]
Basilar-type migraine: clinical, epidemiologic, and genetic features. Neurology. 2006;66(6):880-886. Ying G, Fan W, Li N, et al. Clinical characteristics of basilar-type migraine in the neurological clinic of a university hospital. Pain Medicine. [migraine.com]
Meniere's disease: a 30-year epidemiologic and clinical study in Rochester, MN, 1951-1980. Laryngoscope 94:1098-1102, 1996 [dizziness-and-balance.com]
Pathophysiology
Starting from the neurological point of view, the pathophysiology, classification, neurophysiology and therapy of migraine are discussed. [books.google.com]
Pathophysiology Basilar migraine was initially thought to have vascular pathology caused by short-term spasms of the basilar artery. [ncbi.nlm.nih.gov]
Functional neuroimaging: enhanced understanding of migraine pathophysiology. Neurology. 2000. 55(9 Suppl 2):S36-45. [Medline]. Goadsby PJ. Migraine pathophysiology. Headache. 2005 Apr. 45 Suppl 1:S14-24. [Medline]. Lagman-Bartolome AM, Lay C. [emedicine.medscape.com]
Prevention
Other preventive strategies include following specialized diets and using mind-body techniques such as deep relaxation, visualization, and biofeedback to help people put an end to their headaches. [books.google.com]
Lamictal (lamotramine): Like Topamax, this anticonvulsant calms abnormal excitement in the brain; it's used to prevent seizures and to help manage certain psychiatric conditions such as bipolar disorder. [verywell.com]
Lamotrigine has been shown to be effective in preventing migraine aura symptoms in typical aura and in some cases of BM. We tried lamotrigine in three female cases of BM. [ncbi.nlm.nih.gov]