A wide variety of paroxysmal visual, sensory, and motor disturbances with or without headache is included in the migraine syndrome, but disturbances in consciousness and mental functioning as a part of the migraine syndrome in children are not well recognized.1 In 1970, Gascon and Barlow reported four children, ranging in age from 8 to 16 years, who displayed acute confusional states during an attack of migraine.2 This report describes similar episodes in four additional children in order to call attention to this disorder and provide additional characterization. See figure in PDF file CASE REPORTS Case 1 An 8-year-old girl fell off her sled and rolled down a hill.