Acute Confusional Migraine: Distinct Clinical Entity or Spectrum of Migraine Biology?

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.

Acute Confusional Migraines: A Case Report

“…Should a patient have a pertinent history for ACM, excessive diagnostics should be avoided, a viewpoint that has been held since ACM's identification in the 1970s and well into the 21 st century. 12,13 Image 3. Normal magnetic resonance imaging of the brain.…”

Role of Intravenous Magnesium Sulphate in Acute Status Migranous

“…Status migraous was diagnosed on the basis of the diagnostic criteria of international classification of headache disorder, third edition (ICHD-3) (Headache Classification Committee of the International Headache). [11][12][13] All other primary and secondary causes of headaches were ruled out by detailed history taking, general physical and systemic examination and relevant investigations if required. Visual analogue scale (VAS-10) was applied in order to quantify the headache by the patient himself.…”

Factors Affecting Vision and Visio-Spatial Intelligence (VSI) in Sport: A Review of the Literature

“…Brain fog can be caused by multiple conditions including anemia (69), diabetes (70), lupus (71), multiple sclerosis (72), arthritis (73), Alzheimer's disease (74), hypothyroidism (75), and migraines (76). Athletes are commonly influenced by anemia, diabetes, migraines, and hypothyroidism.…”

“…Headache or migraine pain and ocular symptoms can be connected by two factors: first, trigeminal activation, which causes eye pain and second, autonomic dysfunction in either the sympathetic or parasympathetic pathway that generates autonomic symptoms such as pupillary changes, lacrimation, redness of the eye, and even blurred vision (19). Some individuals have transient neurological disturbances called auras migraines (76). Auras can cause visual, language, motor, and sensory disturbances as well as brainstem symptoms such as dysarthria, vertigo, tinnitus, ataxia, and double vision (76).…”

“…Some individuals have transient neurological disturbances called auras migraines (76). Auras can cause visual, language, motor, and sensory disturbances as well as brainstem symptoms such as dysarthria, vertigo, tinnitus, ataxia, and double vision (76). Thus, those individuals responsible for the care and training of athletes should be aware, when athletes receive a blow to the head, that headache or migraines are likely to occur, and that vision can be affected.…”