In the 24 hours leading up to migraine headaches, people might get stiff necks, food cravings, constipation, mood changes, or frequent urination or yawning. Scientists don't know why these symptoms occur, but they think a hormone-releasing brain region might be involved. Stage 2 is the aura, which usually lingers for less than an hour. Vestibular migraine and migraine with brainstem aura are two principal clinical syndromes that frequently are associated with vertigo. Since cinnarizine is a well-tolerated calcium channel blocker which has acceptable effect on both vertigo and migraine headache, we carried out this study to evaluate the efficacy and safety of this medication symptoms such as fever, seizure, bilateral visual disturbances, a ‘brainstem aura’ with vertigo, dysarthria, ataxia, hyperacusia, tinnitus, impaired consciousness and even, in the worse condi-tions, coma.1 4 10 13 The duration of symptoms is usually 20–60 min but, in some cases, the aura and motor deficit may onset quickly and simu- Introduction. Migraine is a disabling condition that, in addition to headache, also involves often disabling non-headache symptoms. Although the pain phase of the migraine attack is well-recognized and characterized by moderate to severe headache with associated sensory sensitivities such as photophobia and phonophobia, and nausea and vomiting (), increasingly, associated symptomatology such Vestibular migraine (VM) is one of the most common types of episodic vertigo. Over the last 11 years, this disorder has been studied by both neurologists and otolaryngologists. Based on the clinical symptoms and previous migraine history, the Barany Society and the International Classification of Headache Disorders have created the diagnostic . Migraine with brainstem aura (MBA) is a rare migraine subtype 1–15 and accounts for about 1.5% of headache and 6.6–10% of migraine with aura. 16, 17 The aura features include vertigo, dysarthria, diplopia, tinnitus, ataxia, and disorders of consciousness (DOC). 18 Hiccups 19 or exploding head syndrome (EHS) 14 may also occur in some patients. Migraine is an episodic primary headache disorder. Symptoms typically last 4 to 72 hours and may be severe. Pain is often unilateral, throbbing, worse with exertion, and accompanied by symptoms such as nausea and sensitivity to light, sound, or odors. Auras occur in about 25% of patients, usually just before but sometimes after the headache. Also known as a silent migraine, this is an aura without the headache. Rare types of migraine. There are some rare types of migraine, which are also classed as migraine with aura. Migraine with brainstem aura. Previously known as basilar-type migraine, people with this condition experience two or more of the following symptoms before a migraine: Approximately 90% of all patients have their first attack before the age of 50 years. Up to a third of those with migraine experience aura before or during an attack, characterised by reversible neurological symptoms, most typically visual disturbances but also sensory, language, brainstem or motor symptoms. Migraine with brainstem aura is a rare disorder that usually occurs from ages 7-20 years and rarely presents in patients older than 50 years. 37 In one study, the following aura symptoms were reported: vertigo, 61 percent; dysarthria, 53 percent; tinnitus, 45 percent; diplopia, 45 percent; bilateral visual symptoms, 40 percent; bilateral

migraine with brainstem aura symptoms