A migraine with brain stem aura, also known as a basilar migraine headache, is a type of migraine with aura symptoms that originate from the brain stem or bilateral cerebral hemispheres. Aura symptoms include diplopia, dysarthria, vertigo, tinnitus, bilateral visual disturbance, ataxia, bilateral paresthesias, or depressed consciousness. There must be 2 or more of these symptoms together or in succession lasting from 5-60 minutes each. There is no motor weakness. The migraine occurs during aura symptoms or follows within 60 minutes and often is characterized by a throbbing occipital headache with or without nausea. Symptoms completely resolve after the attack.
Age of onset is typically between 7 and 20 years old, and it is more common in women than in men. This type of headache may remit or transform into typical migraine with age.