(LifeWire) - Before a basilar-type headache begins, it may predict its own arrival with symptoms that can include confusion, dizziness, impaired hearing and perhaps even double vision.
These symptoms, which can terrify a patient, may be misunderstood by physicians and others and seen as evidence of intoxication. Therefore, experts recommend that people who experience basilar-type headaches keep some form of medical identification with them at all times.
Symptoms and Diagnosis
Basilar-type headaches are considered a subtype of migraine with aura. In addition to the headache, someone experiencing a migraine with aura can have debilitating symptoms for more than 5 hours -- on average, 1 hour -- prior to the onset of headache pain.
These symptoms can affect the entire body, including one's ability to see, hear and experience sensations.
Most studies report these basilar-type headache symptoms with the median duration of 1 hour. The aura symptoms include not only confusion, dizziness, ringing in the ears, impaired hearing and double vision, but can also cause loss of consciousness, racing heart rate, changes in breathing, paralysis or numbness on one side of the body, and visual aura elements, such as sparks or flashes of light, and areas of diminished vision.
According to one study, 53% of patients with basilar-type headaches reported experiencing dysarthria. This medical term refers to slurring of words, difficulty chewing or swallowing, and changes in normal voice tone and volume from weakening of the muscles in the face and mouth, usually due to neurological injury.
Patients must have had two or more headache attacks with at least two of the specific aura symptoms previously outlined before a diagnosis of basilar-type headaches will be made.
Who Gets Basilar-Type Headaches?
Although the exact prevalence of these headaches is not known, a Danish study of 362 people who experienced migraine with aura found that 26 people -- about 7% -- had basilar-type headaches.
As with migraines and the general category of migraines with aura, basilar-type headaches are more common among women; however, definitive statistics on the increased frequency are unavailable.
Often these headaches also impact young adults and children. The average onset typically occurs before the age of 25. For most of these individuals, the headaches continue throughout adulthood.
Causes and Triggers
Researchers initially believed that blood flow restriction in the basilar artery caused basilar-type headaches. This cause has not been ruled out entirely, but current research suggests that basilar-type headaches, like other migraines with aura, are caused by a dysfunction of brain nerve cells.
In migraine with aura, research suggests that chemical impulses are moving through the visual processing center of the brain. For patients with basilar-type headaches, research suggests that similar chemical impulses are affecting both the visual processing center and the brain stem, which controls breathing, heart rate, blood pressure and alertness.
So what does this mean for patients?
Many of the triggers and treatments thought to initiate and mitigate migraines with typical aura are likely to trigger and treat basilar-type headaches as well.
Because auras are associated with migraines, typical migraine triggers may also be responsible for basilar-type headaches with aura. Migraine triggers include certain substances we ingest, such as alcohol, aged cheeses, chocolates and foods containing aspartame. These triggers also include stress at work or at home, sensory stimuli such as bright lights or sun glare, and changes in the sleep-wake pattern, such as missing sleep or getting too much sleep.
Women have reported that hormones may trigger their headaches. About 60% of women who were questioned about this reported that their migraines increased in both intensity and frequency during their menses. Women with a history of migraines should talk to their doctor before beginning birth control or hormone replacement therapy.
Treatment Options
Treatment options range from simple lifestyle changes to prescriptions, with over-the-counter (OTC) medications residing in the middle of the treatment continuum. Anti-inflammatory medications, both OTC and prescription strength, have been shown to be successful in treating migraine headache pain. Researchers have also looked at topiramate (Topamax) -- a prescription anti-convulsant medication that works by decreasing abnormal brain activity -- as a treatment option.
In 2007, a trial study of 14 children was reported in Headache: The Journal of Head and Face Pain, in which half were prescribed 25mg doses of topiramate daily and the other half received 100-mg doses daily. In this particular case study, the participants experienced headaches with a median duration of 5.5 hours for those taking the 25-mg doses and 5 hours for those taking the 100-mg doses.
Overall, most of the patients (86%) reported more than a 50% reduction in their migraine frequency. Migraine duration was reduced by an average of 18 minutes for those taking the 25-mg dose and by 89 minutes for those taking the 100-mg dose.
Topiramate does have potential side effects, including dizziness, confusion, difficulty concentrating and an increased risk of osteoporosis. Topiramate can also hinder the body's ability to sweat, so care should be taken in warm weather to ensure that you do not overheat.
In addition to medication and lifestyle changes, physicians also recommend starting a headache journal. Journal entries should include time of headache onset, activity engaged in during the time of onset, and headache frequency, duration and relative intensity. This information can be helpful in determining triggers and establishing a treatment program.
Sources:
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Kirchmann, Malene, Lise Lykke and Jes Olesen. "Basilar-Type Migraine." Neurology 66, 2006.
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Lewis, Donald, and Erika Paradiso.. "A Double-Blind, Dose Comparison Study of Topiramate for Prophylaxis of Basilar-Type Migraine in Children: A Pilot Study." Headache 47, 10 Nov/Dec 20007 1409-1417. 10 Apr. 2008. <www.blackwell-synergy.com/doi/abs/10.1111/j.1526-4610.2007.00867.x?prevSearch=allfield%3A%28basilar%29>.
Mayo Clinic Staff. "Migraine." MayoClinic.com. 2007. Mayo Clinic. 10 Apr. 2008. <www.mayoclinic.com/health/migraine-headache/DS00120>.
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