Migraine with brainstem aura (basilar-type migraine)
Drugs of concern — Although data are scant and conflicting, we suggest not using beta blockers, triptans, or ergotamine derivatives to treat patients with MBA because of theoretical concerns and anecdotal evidence that these medications may lead to cerebral ischemia.
Many headache specialists also avoid beta blockers as preventive therapy for patients who have MBA, hemiplegic migraine, or migraine with prolonged aura [27]. The concern is that beta blockers may potentially limit compensatory vasodilatory capacitance of cerebral vessels. Similar to hemiplegic migraine, there is anecdotal evidence that beta blockers may lead to ischemia in patients with MBA [27,28]. However, there are at least three case reports showing an excellent response to treatment with beta blockers [29].
То есть, хотя нет доказательств того, что в патогенезе ауры ствола участвует ишемия, бета-блокаторы, которые потенциально могут её усилить, пока на сегодняшний день в целом не рекомендуются.
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