Basilar Artery Migraine Basilar artery migraine ( or Basilar as some would prefer to call it ) is not a separate category in the new IHS classification, however, it is described separately because of its clinical manifestations. The symptoms are similar to those one might expect with ischemia in the posterior circulation, namely: bilateral disturbance of vision, ataxia, dysarthria, vertigo, tinnitus, and face or limb paresthesias, followed by severe throbbing headache usually in the occipital region. While a definite diagnosis of migraine was impossible to prove, the mode of onset, the associated headache, the relatively brief duration of the attack, the family history of migraine, the occurrence of other attacks more typically migrainous, and the absence of all neurologic abnormality between episodes made the diagnosis of migraine most likely. Therapy for these patients has included ergonovine maleate, propranolol, phenytoin, and primidone. It is of interest that anticonvulsants are effective in many patients.