In making a differential diagnosis for Basilar Artery Migraine, neurologists should look for the presence of two or more of the typical symptoms, which include vertigo, tinnitus, decreased or impaired hearing, ataxic gait, dysarthria, visual symptoms (normally in both eyes), diplopia, bilateral paresthesias or paresis, and impaired consciousness.

These symptoms are usually, although not necessarily, followed by a throbbing headache in the occipital region (the back of the head). The vertigo that accompanies Basilar Artery Migraine normally lasts between 5 minutes and one hour.

The other neurological and brainstem symptoms associated with Basilar Artery Migraine generally also last between 5 and 60 minutes, though there may be residual neurologial symptoms that persist after the attack itself is resolved.

Differential diagnosis of BAM should include thrombosis of the basilar artery or cerebral veins, TIA, stroke, subarachnoid hemorrhage, cerebellar hemorrhage, cerebellar infarction, brainstem infarction, metabolic disorders, aneurysm, tumors of the posterior fossa, drug intoxication, epilepsy, other migraine variants, and mental disorders.

It is vital that the neurologist obtain as thorough a history as possible from the patient, including the patient's headache background and characteristics, and information on any family history of related disorders.