What is acute confusional migraine?

Updated: Aug 15, 2019
  • Author: William C Robertson, Jr, MD; Chief Editor: Amy Kao, MD  more...
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Acute confusional migraine is not classified under the ICHD-3 (beta). This type of migraine is uncommon and usually occurs early in the second decade of life. Acute confusional migraines are characterized by transient episodes of amnesia, acute confusion, agitation, lethargy, and dysphasia precipitated by minor head trauma. Affected children are delirious, restless, and combative and appear to be in pain, but they do not complain of headache.

The child may have a receptive or expressive aphasia, and the confusional state may either precede or follow the headache. Some children also experience recurrent episodes of transient amnesia and confusion.

Episodes typically last less than 6 hours and are followed by deep sleep. Upon awakening, the child is normal and is amnestic for the attack.

The child may not have a history of headache, but he or she usually develops typical migraine attacks in the future. Exclude drug abuse; brain magnetic resonance imaging (MRI) results should be normal.

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