Question:medium
A girl presented with recurrent occipital headache associated with ataxia and vertigo. Her mother also has similar complaints. The most probable diagnosis is?
A girl presented with recurrent occipital headache associated with ataxia and vertigo. Her mother also has similar complaints. The most probable diagnosis is?
Show Hint
Occipital headache with brainstem signs and a family history equals a posterior-circulation migraine.
Updated On: Jun 24, 2026
- Vestibular neuronitis
- Basilar migraine
- Tension headache
- Cluster headache
Show Solution
The Correct Option is B
Solution and Explanation
Localise the problem first. The pain sits at the back of the head and is accompanied by unsteadiness and a spinning sensation, all of which trace to the structures fed by the basilar artery, that is, the brainstem and cerebellum. So the diagnosis must be one that produces episodic brainstem dysfunction.
Layer in the inherited pattern. The mother carries the same complaints, which signals a familial, recurrent disorder. Migraine is strongly heritable, and the basilar subtype, seen mostly in young women, generates exactly these brainstem aura features of vertigo, ataxia, and occipital headache.
Run through the alternatives. Vestibular neuronitis is a one-off attack of severe vertigo from vestibular nerve inflammation, without headache or a family thread. A tension headache is a dull band-like ache lacking any vertigo or imbalance. A cluster headache is an excruciating unilateral eye-centred pain with tearing and nasal stuffiness, again with no ataxia. None of these explains the combined hereditary brainstem picture.
The unifying answer is therefore migraine of the basilar type.
\[\boxed{\text{Basilar migraine}}\]
Layer in the inherited pattern. The mother carries the same complaints, which signals a familial, recurrent disorder. Migraine is strongly heritable, and the basilar subtype, seen mostly in young women, generates exactly these brainstem aura features of vertigo, ataxia, and occipital headache.
Run through the alternatives. Vestibular neuronitis is a one-off attack of severe vertigo from vestibular nerve inflammation, without headache or a family thread. A tension headache is a dull band-like ache lacking any vertigo or imbalance. A cluster headache is an excruciating unilateral eye-centred pain with tearing and nasal stuffiness, again with no ataxia. None of these explains the combined hereditary brainstem picture.
The unifying answer is therefore migraine of the basilar type.
\[\boxed{\text{Basilar migraine}}\]
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