We studied aura symptoms in 83 patients from 6 unrelated families suff
ering from familial hemiplegic migraine. Fifty-five of the patients re
ported symptoms that allowed us to categorize them as basilar migraine
(BM) patients, in accordance with the International Headache Society
(IHS) criteria. In a control group of 33 patients suffering from migra
ine with aura and 33 patients suffering from migraine without aura, 9
patients complained of vertigo, and only one patient of diplopia durin
g one of her attacks. None of these control patients fulfilled the IHS
criteria for BM. We suggest that familiar hemiplegic migraine and BM
may share certain pathophysiologic mechanisms, which may consist of a
(genetically determined)disturbance of basilar artery blood flow.