Basilar-type migraine.

Initially described more than 40 years ago, basilar-type migraine has posed diagnostic and therapeutic dilemmas for medical practitioners. Defined by the coexistence of migraine headache with neurological symptoms emanating from either the brainstem or simultaneously from both cerebral hemispheres, basilar-type migraine has been categorized as "atypical" or "complicated" and has been considered more akin to hemiplegic migraine than to migraine with typical aura. Despite the absence of any data convicting basilar-type migraine as a vasospastic condition, the use of triptans in such patients has been considered prohibited. This review focuses on the diagnosis, clinical presentation, available genetic information, and treatment considerations in patients with basilar-type migraine.