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Basilar-Type Migraine

Basilar Type Migraine


Presentation

  • Literatures of migraineurs presented with coma were reviewed. RESULTS: The two patients are partially resolved with prophylactic propranolol or valproate therapy.[ncbi.nlm.nih.gov]
  • All patients received structured interview of clinical presentations and underwent a battery of audiovestibular function tests.[ncbi.nlm.nih.gov]
  • This review focuses on the diagnosis, clinical presentation, available genetic information, and treatment considerations in patients with basilar-type migraine.[ncbi.nlm.nih.gov]
  • 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]
  • The signs and symptoms of neurological disease are elusive by their very nature, presenting a confounding diagnostic challenge.[books.google.com]
Falling
  • These children continue to "fall through the cracks" of our medical education system.[books.google.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]
  • I feel like I am being gently pushed over and often end up falling against walls.[tapatalk.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]
Tinnitus
  • The basilar-type aura comprised diplopia 52%, vertigo 43%, tinnitus 43%, bilateral visual symptoms 39%, hypacusia 26%, ataxia 26%, dysarthria 22%, bilateral paresthesias 13%, and decreased level of consciousness 13%.[ncbi.nlm.nih.gov]
  • 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]
  • […] 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, 20 percent Weakness , 20 percent Tinnitus[migraine.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]
  • 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]
Diplopia
  • The basilar-type aura comprised diplopia 52%, vertigo 43%, tinnitus 43%, bilateral visual symptoms 39%, hypacusia 26%, ataxia 26%, dysarthria 22%, bilateral paresthesias 13%, and decreased level of consciousness 13%.[ncbi.nlm.nih.gov]
  • 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]
  • BACKGROUND: Basilar-type migraine (BM) is the most common migraine "variant," representing 3-19% of migraine in children.BMis characterized by attacks of dizziness, vertigo, visual disturbances, ataxia, and/or diplopia, followed by migraine headache.[ncbi.nlm.nih.gov]
  • 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]
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]
Facial Edema
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]
  • Headache. 2010 Jun;50(6):1057-9. doi: 10.1111/j.1526-4610.2010.01682.x. Epub 2010 May 7. Author information 1 Cleveland Clinic Neurological Institute-Neurology, Center for Headache and Pain, Cleveland, OH, USA.[ncbi.nlm.nih.gov]
  • […] due to headache for the past 8 years.[ncbi.nlm.nih.gov]
  • Headache. 2009 Jul;49(7):1042-6. doi: 10.1111/j.1526-4610.2009.01464.x. Epub 2009 May 27. Author information 1 The Montefiore Headache Center, Saul R.[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]
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]
  • Interestingly, p.Tyr1245Cys was detected in a patient displaying a changing, age-specific phenotype that began as benign paroxysmal torticollis of infancy, evolving into benign paroxysmal vertigo of childhood and later becoming HM.[ncbi.nlm.nih.gov]
  • The basilar-type aura comprised diplopia 52%, vertigo 43%, tinnitus 43%, bilateral visual symptoms 39%, hypacusia 26%, ataxia 26%, dysarthria 22%, bilateral paresthesias 13%, and decreased level of consciousness 13%.[ncbi.nlm.nih.gov]
  • 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]
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]
  • 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]
  • 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]
Ataxia
  • Abstract 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 basilar-type aura comprised diplopia 52%, vertigo 43%, tinnitus 43%, bilateral visual symptoms 39%, hypacusia 26%, ataxia 26%, dysarthria 22%, bilateral paresthesias 13%, and decreased level of consciousness 13%.[ncbi.nlm.nih.gov]
  • 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]
  • BACKGROUND: Basilar-type migraine (BM) is the most common migraine "variant," representing 3-19% of migraine in children.BMis characterized by attacks of dizziness, vertigo, visual disturbances, ataxia, and/or diplopia, followed by migraine headache.[ncbi.nlm.nih.gov]
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]
  • 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]
  • However, the symptoms can confuse everyone including Emergency personnel. My first bad BTM threw the ER staff for a loop while they ran CAT scans of my brain and ordered up a lumbar puncture (spinal tap) of my spine.[atomiccity.blogspot.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]

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 2 treatment groups resulted in comparable outcomes.[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]
  • This review focuses on the diagnosis, clinical presentation, available genetic information, and treatment considerations in patients with basilar-type migraine.[ncbi.nlm.nih.gov]

Prognosis

  • Disability and Prognosis As with other forms of migraine, migraine with brainstem aura can be disabling.[americanmigrainefoundation.org]
  • […] 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]

Etiology

  • The first chapter stresses the etiology and pathophysiology of childhood stroke as the basis for evaluations and treatment.[books.google.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: 880-886. Klapper J, Mathew N, Nett R. Triptans in the treatment of basilar migraine and migraine with prolonged aura. Headache. 2001;41:981-984.[americanmigrainefoundation.org]
  • 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]
Sex distribution
Age distribution

Pathophysiology

  • Starting from the neurological point of view, the pathophysiology, classification, neurophysiology and therapy of migraine are discussed.[books.google.com]
  • The first chapter stresses the etiology and pathophysiology of childhood stroke as the basis for evaluations and treatment.[books.google.com]

Prevention

  • 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]
  • Adequate care should be taken to prevent migraine attacks. Wiley Periodicals, Inc.[ncbi.nlm.nih.gov]
  • That positive 1-year experience leaded us to suggest that lamotrigine could be a preventive therapeutic option for BM patients, with and without menstruation association.[ncbi.nlm.nih.gov]
  • 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]
  • Of the preventive medications, topiramate, verapamil and lamotrigine are most commonly used.[americanmigrainefoundation.org]

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