Alteração do estado de consciência: uma causa rara

Abstract

Introduction: Acute alterations of consciousness in children represent a challenging diagnosis due to the diversity of possible pathologies and their eventual severity. Although they are mostly caused by pathologies commonly observed in clinical practice, there are also rare causes.Case report: A fifteen-year-old girl was admitted in the emergency because of disorientation, psychomotor agitation, unintelligible speech and incoercible vomiting. She was conscious, auto and allopsychically disoriented, agitated, dysarthric, afebril and hemodynamically stable. Cerebral imaging and laboratorial complementary diagnostic tests were innocent. After clinical improvement with recovery of the initial symptoms, she presented headache with phonophobia and photophobia. She was discharged from hospital after 48 hours, asymptomatic, diagnosed with acute confusional migraine.Discussion: It’s a rare cause of alteration of consciousness and its presentation can be ostentatious. Being an exclusion diagnosis it’s important to be aware of the existence of acute confusional migraine so that it can be taken into account in differential diagnosis of an acute alteration of consciousness.