Written by Maria Gabrielle, Migraine Health Writer & Researcher
Basilar migraine and basilar-type migraine are older terms for migraine with brainstem aura. It is a specific type of migraine with aura that can involve temporary neurological symptoms such as vertigo, double vision, ringing in the ears, difficulty articulating speech or unsteadiness.
These symptoms can feel frightening and may overlap with symptoms of conditions that need urgent assessment. For that reason, migraine with brainstem aura should be diagnosed by a qualified healthcare professional, not self-diagnosed from symptoms alone.
For plain-English definitions of terms including aura, vertigo and brainstem migraine, explore our Migraine A-Z Glossary.
Key points
- Migraine with brainstem aura is the current term for what was previously called basilar or basilar-type migraine.
- Diagnosis requires a specific pattern of fully reversible aura symptoms, not just one symptom such as dizziness or blurred vision.
- According to ICHD-3 criteria, at least two brainstem symptoms are required for this classification.
- Motor weakness and retinal symptoms do not fit the criteria for migraine with brainstem aura and need medical assessment.
- New, sudden, severe or different neurological symptoms should always be assessed urgently.
- No food supplement has been proven to diagnose, treat or prevent migraine with brainstem aura.
What is migraine with brainstem aura?
Migraine with brainstem aura is a recognised subtype of migraine with aura. The International Classification of Headache Disorders, known as ICHD-3, lists older names including basilar artery migraine, basilar migraine and basilar-type migraine.
The term “basilar migraine” is no longer preferred because it suggested that the basilar artery was the cause. ICHD-3 notes that involvement of the basilar artery is unlikely, which is why the current term is migraine with brainstem aura.
The exact biological mechanism is not fully understood. What matters clinically is the pattern of symptoms, their timing, whether they are fully reversible, and whether another cause needs to be ruled out.
For a broader overview of migraine aura symptoms, including visual, sensory and speech symptoms, read our dedicated guide.
How clinicians classify migraine with brainstem aura
| Feature | What it means |
|---|---|
| Current term | Migraine with brainstem aura. |
| Older terms | Basilar migraine, basilar artery migraine and basilar-type migraine. |
| Diagnostic pattern | At least two attacks that meet migraine-with-aura criteria and include at least two fully reversible brainstem symptoms. |
| Brainstem symptoms | Dysarthria, vertigo, tinnitus, reduced hearing, double vision, ataxia or reduced level of consciousness. |
| Motor symptoms | Motor weakness does not fit this classification and needs medical assessment. |
| Retinal symptoms | Retinal symptoms do not fit this classification and should not be assumed to be brainstem aura. |
| Timing | For migraine aura generally, each individual aura symptom usually lasts 5 to 60 minutes and often develops gradually. |
Read the ICHD-3 criteria for migraine with brainstem aura and the wider ICHD-3 criteria for migraine with aura.
Symptoms linked with brainstem aura
One symptom on its own does not establish migraine with brainstem aura. Clinicians look at the full symptom pattern and exclude other possible causes.
| Symptom | How it may feel | Important distinction |
|---|---|---|
| Dysarthria | Difficulty articulating words clearly. | This is different from aphasia, which affects language or word-finding. |
| Vertigo | A spinning or false sense of movement. | Vertigo is not the same as vague dizziness or feeling light-headed. |
| Tinnitus | Ringing, buzzing or other sounds in the ears. | Ear fullness alone does not meet the ICHD-3 criterion. |
| Hypacusis | Temporary reduced hearing. | This should be discussed with a clinician, especially if it is new or one-sided. |
| Diplopia | Seeing double. | Double vision is different from blurred vision. |
| Ataxia | Unsteadiness or poor coordination. | This must not be explained only by sensory loss or another condition. |
| Reduced consciousness | Marked drowsiness or reduced awareness. | This requires urgent medical assessment, particularly if it is new or unexplained. |
For a wider overview of visual symptoms of migraine, including why new or unusual symptoms need medical assessment, read our dedicated guide.
What to do during symptoms
- Get somewhere safe. Sit or lie down and avoid driving, climbing, cooking or operating machinery while your balance, vision or awareness feels affected.
- Make a note of the time. Record when symptoms began, how they developed and when they settled.
- Notice the full symptom pattern. Include headache, nausea, light sensitivity, numbness, weakness, confusion, hearing changes or vision changes.
- Use your existing medical plan. Follow any individual migraine plan agreed with your GP, neurologist or pharmacist.
- Do not self-label a new episode. Symptoms such as speech difficulty, double vision, poor balance or reduced consciousness need clinical advice, especially when new or different.
When to seek urgent medical help
Call 999 if you have a sudden, extremely painful headache; problems speaking or remembering; loss of vision; blurred or double vision; severe drowsiness or confusion; a seizure; one-sided weakness; facial drooping; or symptoms after a head injury.
Seek urgent advice from NHS 111 or an urgent GP appointment if aura symptoms last longer than 1 hour, a migraine attack lasts longer than 72 hours, or symptoms are severe, changing or difficult to control.
Read the NHS guidance on migraine symptoms and urgent help.
Keeping a migraine and symptom diary
A diary cannot diagnose migraine with brainstem aura, but it can help your GP or headache specialist understand the pattern. NICE recommends recording headache information for at least 8 weeks when a diary is used.
| What to record | Why it helps |
|---|---|
| Date, start time and end time | Helps show how symptoms develop and how long they last. |
| Symptoms in order | Useful for distinguishing vertigo, speech changes, visual symptoms and headache phases. |
| Headache details | Record severity, duration, location and associated symptoms. |
| Medicines taken | Includes prescribed and over-the-counter medicines. |
| Possible patterns | Sleep, meals, hydration, stress, illness, alcohol, caffeine and menstruation may be useful context to discuss with a clinician. |
| What helped or worsened symptoms | Supports a more informed conversation about future management. |
Read NICE guidance on headache diaries and migraine management.
Everyday support after diagnosis
Once a clinician has assessed your symptoms, your management plan may include acute treatment, preventive treatment, lifestyle adjustments or referral to a specialist. The right approach depends on your symptoms, medical history, other medicines and how often attacks occur.
Some people find it useful to keep meals and sleep as regular as possible, stay hydrated and identify personal patterns through a diary. These approaches are not a substitute for medical assessment and should not delay urgent care for new neurological symptoms.
For broader prevention habits to discuss with a healthcare professional, read our Natural Migraine Prevention Guide.
A note on supplements
Migraine with brainstem aura should not be self-treated with a food supplement. No food supplement has been proven to diagnose, treat or prevent this condition.
MigraSoothe products are food supplements, not medicines. They are not intended to diagnose, treat, cure or prevent migraine with brainstem aura, migraine or any other disease. Speak to your GP, neurologist or pharmacist before starting a supplement, particularly if you are pregnant, breastfeeding, taking prescription medication or managing another health condition.
For general information about migraine symptoms that can occur with little or no headache, read our guide to silent migraines.
For non-medical questions about MigraSoothe products, ingredients and ordering, visit our FAQs.
Frequently asked questions
Is basilar migraine the same as migraine with brainstem aura?
Basilar migraine and basilar-type migraine are older names. The current ICHD-3 term is migraine with brainstem aura.
Is one symptom enough for a diagnosis?
No. The ICHD-3 classification requires at least two fully reversible brainstem symptoms as part of a migraine-with-aura pattern. A clinician must also consider other possible causes.
Can migraine with brainstem aura happen without a headache?
It can be possible to have aura symptoms with little or no headache. However, new symptoms still need medical assessment because they can overlap with other neurological conditions.
Is migraine with brainstem aura the same as vestibular migraine?
No. Vestibular migraine and migraine with brainstem aura are different classifications. Vertigo alone does not meet the criteria for migraine with brainstem aura.
Does blurred vision count as double vision?
No. Blurred vision and double vision are different symptoms. ICHD-3 specifically distinguishes diplopia, or double vision, from blurred vision.
Can migraine with brainstem aura cause weakness?
Motor weakness does not fit the ICHD-3 criteria for migraine with brainstem aura. New weakness, facial drooping or one-sided symptoms need urgent medical assessment.
Can stress, sleep changes or dehydration trigger it?
People with migraine may notice personal patterns involving sleep, stress, meals, hydration or caffeine. These are not diagnostic and are not proven to be specific triggers for migraine with brainstem aura.
Do I need a brain scan?
Not everyone needs imaging. A GP, neurologist or emergency clinician will decide whether tests are appropriate based on your symptoms, medical history and examination.
Can supplements treat migraine with brainstem aura?
No food supplement has been proven to treat migraine with brainstem aura. Supplements should never replace medical assessment, prescribed treatment or urgent care.
When should I call 999?
Call 999 for sudden severe headache, speech or memory problems, loss of vision, double vision, confusion, seizure, one-sided weakness, facial drooping or symptoms after a head injury.
Sources and further reading
- International Classification of Headache Disorders: Migraine with brainstem aura
- International Classification of Headache Disorders: Migraine with aura
- NICE: Headaches in over 12s: diagnosis and management
- NHS: Migraine
Medical disclaimer
This article is for general information only and does not replace personalised medical advice. Migraine with brainstem aura can resemble other neurological conditions, so new, sudden, severe or changing symptoms should be assessed urgently. MigraSoothe products are food supplements and are not medicines.