Bickerstaff's Syndrome (Basilar Migraine)


When migraine affects the circulation in back of the brain or neck, it can cause basilar migraine or Bickerstaff's syndrome.


It occurs most frequently in young women. Symptoms include:

  • Dizziness.

  • Double vision.

  • Loss of balance.

  • Confusion.

  • Slurred speech.

  • Fainting.

  • Disorientation.

  • During the severe (acute) headache, some people lose consciousness.

Often these patients are mistakenly thought to be intoxicated, under the influence of drugs, or suffering from other conditions. A previous history of migraine is helpful in making the diagnosis.


Basilar migraines are treated medically the same as all other migraines.


  • If this is your first diagnosed migraine headache, you may simply choose to wait and watch. You can wait to see if you have another headache before deciding on a further treatment.

  • You may consult your caregiver or do as suggested by the current treating caregiver.

  • Numerous medications can prevent these headaches if they are recurrent or should they become recurrent. Your caregiver can help you with a medication or treatment program that will be helpful to you.

  • If this has been a chronic (long-standing) condition, using continuous narcotics is not recommended. Using long-term narcotics can cause recurrent migraines. Narcotics are a temporary measure only. They are used for the infrequent migraine that fails to respond to all other measures.


  • You do not get relief from the medications given to you or you have a recurrence of pain.

  • You have an unexplained oral temperature above 102° F (38.9° C), or as your caregiver suggests.

  • You have a stiff neck.

  • You have loss of vision.

  • You have muscular weakness.

  • You have loss of muscular control.

  • You develop severe symptoms different from your first symptoms.

  • You start losing your balance or have trouble walking.

  • You feel faint or pass out.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.