Abstract
The goal of this review is to explore the literature reports of acute confusional migraine (ACM) including patient characteristics, migraine symptomatology, and proposed diagnostic criteria. A literature review was conducted using PubMed, Scopus and Web of Science using the terms “confusional migraine” and “confusional state in migraine”. All the relevant articles from 1970 to 2016 were included. A total of 120 patients were found in the literature. Most of the cases were seen in the pediatric population with a slight male predominance. Personal or family history of migraine was common. Most patients had a headache prior to the confusional state. In addition to confusion and agitation, some developed visual (32.5%) and/or sensory symptoms (19%) and/or speech problems (39%) either prior to or during the confusional state. Data on treatment outcomes is lacking. Patients with most common forms of migraine report attention and cognitive disturbances but awareness remains intact as opposed to patients with ACM. ACM is a distinct entity and should be included as part of the appendix of International Classification of Headache Disoders-3 beta version (ICHD-3β) criteria. Prospective studies are needed to further study this disorder and its association with other migraine forms.
Highlights
Migraine is best thought of as a multiphasic brain disorder, often with a premonitory and postdrome phase associated with the headache
Features The prevalence of these migraine variants varies in literature
acute confusional migraine (ACM) manifests with acute confusion, agitation, disorientation, speech difficulties and memory with acuteseen confusion, agitation, disorientation, difficultiesseen andin memory deficits
Summary
Migraine is best thought of as a multiphasic brain disorder, often with a premonitory and postdrome phase associated with the headache. The diagnosis is characterized by moderate to severe pain intensity, usually unilateral, lasting from 4–72 h, in addition to other associated symptoms such as nausea, vomiting, sensitivity to light, sound, and movement. Some patients have transient neurological disturbances called auras. Language, motor and sensory disturbances as well as brainstem symptoms as dysarthria, vertigo, tinnitus, ataxia, double vision, and decreased loss of consciousness. Migraine is a common type of headache in the pediatric population, but the attacks can differ from those in the adult population.
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