| IHS | Diagnosis | ICD-10 |
|---|---|---|
| 1.2.6 | Basilar-type migraine | G43.103 |
| Previously used terms | Basilar artery migraine, basilar migraine | |
Description:
Migraine with aura symptoms clearly originating from the brainstem and/or from both hemispheres simultaneously affected, but no motor weakness.
Diagnostic criteria:
- At least 2 attacks fulfilling criteria B-D
- Aura consisting of at least two of the following fully reversible symptoms, but no motor weakness:
- dysarthria
- vertigo
- tinnitus
- hypacusia
- diplopia
- visual symptoms simultaneously in both temporal and nasal fields of both eyes
- ataxia
- decreased level of consciousness
- simultaneously bilateral paraesthesias
- At least one of the following:
- at least one aura symptom develops gradually over ≥5 minutes and/or different aura symptoms occur in succession over ≥5 minutes
- each aura symptom lasts ≥5 and ≤60 minutes
- Headache fulfilling criteria B-D for 1.1 Migraine without aura begins during the aura or follows aura within 60 minutes
- Not attributed to another disorder1
Note:
- History and physical and neurological examinations do not suggest any of the disorders listed in groups 5-12, or history and/or physical and/or neurological examinations do suggest such disorder but it is ruled out by appropriate investigations, or such disorder is present but attacks do not occur for the first time in close temporal relation to the disorder.
Comments:
Basilar-type attacks are mostly seen in young adults. Many patients who have basilar-type attacks also report attacks with typical aura (code for both disorders).
If motor weakness is present, code as 1.2.4 Familial hemiplegic migraine or 1.2.5 Sporadic hemiplegic migraine. Patients with 1.2.4 Familial hemiplegic migraine have basilar-type symptoms in 60% of cases. Therefore, 1.2.6 Basilar-type migraine should be diagnosed only when no motor weakness occurs.
Many of the symptoms listed under criterion B are subject to misinterpretation as they may occur with anxiety and hyperventilation.
Originally the terms basilar artery migraine or basilar migraine were used but, since involvement of the basilar artery territory is uncertain (ie,the disturbance may be bihemispheric), the term basilar-type migraine is preferred.
