Though BAM is a migraine variant, and therefore technically belongs
under the classification of "migraine," a BAM attack can
also represent a form of "acute cerebral vascular insufficiency."
The other forms of migraine variant are (1) retinal migraine, (2)
opthalmoplegic migraine, (3) hemiplegic migraine, (4) facial migraine,
and (5) migrainous infarction.
Of these, only hemiplegic migraine has been found to be a dominant
characteristic in terms of heritability in families. Hemiplegic
migraine is also the only form of migraine for which a gene has
been located. It is a gene located on chromosome 19 that carries
the trait for hemiplegic migraine. Hemiplegia can develop either
before or during a migraine. Though Basilar Artery Migraine is certainly
a distinct form of migraine variant, BAM patients can exhibit the
signs of hemiplegic migraine.
The last category of migraine variants listed above, that of migrainous
infarction, deserves special note when discussing BAM.
BAM and Other Migraine Classifications
In very simple terms, migraines can be divided into two broad classes:
common migraine and classic migraine. The common migraine, of which
there are several forms, does not normally have what is called an
"aura." Classic migraines, however, do have this aura.
In fact, they are also sometimes referred to as, simply, "migraine
with aura." Conversely, common migraine may also be referred
to as "migraine without aura." A rough estimate is that
about 80% of all migraines are common migraines, leaving the other
20% as classic migraines.
BAM is a variant of classic migraine, as it has an aura. However,
it is quite different from most classic migraines in how it manifests
itself and its other clinical aspects.
Migraine Aura Without Headache
Migraine aura without headache (formerly called migraine equivalent
or acephalic migraine) refers to visual, neurologic, or gastrointestinal
symptoms occurring transiently and without headache. These symptoms
occur in persons who have had previous migraines, or who have a
family history of migraine. In some cases, they can also occur in
people who have never had migraines.