Confusional migraine is a rare type of migraine headache that typically affects children and teenagers. Symptoms include confusion, agitation, and disorientation. Healthcare professionals may refer to it as acute confusional migraine (ACM).
According to the Migraine Research Foundation, 10% of children in the United States experience migraine. An older study from 2012 notes that ACM affects approximately
Understanding symptoms of ACM can help a person know when they have common headaches or when they need further medical evaluation.
This article takes a closer look at the symptoms, causes, and treatment options for ACM.
Healthcare professionals classify migraine as moderate-to-severe pain that is often located on one side of the head. The pain can last for
Other symptoms usually include:
People may also experience auras, which can cause visual, language, and sensory disturbances.
ACM is a
- speech difficulties
- loss of memory
The symptoms of ACM
A person can experience the headache before, during, or after the state of confusion. However, the headache occurs beforehand for
Other symptoms may include:
- speech problems
- memory problems
- blurred vision
By the end of the migraine episode, people may feel drowsy or fall asleep. They may also not remember what has happened.
Any child showing these symptoms should undergo an evaluation from a physician or specialist to accurately diagnose symptoms and explain various treatment options.
How long do the episodes last?
The confusion can last between a few minutes and 72 hours.
According to a
However, a healthcare professional may recommend the following medications to help treat and prevent episodes of ACM in children:
- Topiramate: Topiramate is a form of anti-epileptic medication. When topiramate is used as a preventive treatment, a healthcare professional may prescribe
15 milligrams (mg) per day. This may increase over time to 2–3 mg per kilogram (kg) (mg/kg) once per day.
- Valproic acid and sodium valproate: This is another form of anti-epileptic medication. A healthcare professional may prescribe
10–15 mg/kg, divided into two doses per day. However, valproic acid is not suitable for females, as it can cause adverse effects such as weight gain, hair loss, and liver insufficiency.
- Prochlorperazine: This is an antinausea medication. A healthcare professional can administer this medication intravenously.
It is important to note that the above doses are for children. Adults with ACM will receive different doses.
Other potential treatment options include:
- nonsteroidal anti-inflammatory drugs
- calcitonin gene-related peptide receptor antagonists
- tricyclic antidepressants
- calcium channel blockers
Part of treating ACM may also include figuring out the cause.
There is ongoing research into the cause of ACM.
However, research from 2012 states that
ACM also appears to affect males
To get the correct diagnosis, a doctor may use the process of elimination. This is because similar symptoms appear in other conditions, such as:
Doctors may use techniques that help diagnose all types of migraine.
The physician will ask about information regarding a person’s:
- medical and psychological history
- family medical history
The doctor will also look at:
- current and past medications
Documenting migraine history and details can help discover patterns or reasons for migraine.
Doctors may also order images, tests, and scans to make sure there are not any tumors or irregularities in the brain. MRI and CT scans are examples of imaging procedures.
Testing blood work also ensures no underlying medical conditions are causing migraine.
The results of the evaluation and tests can help create a treatment plan.
As there is ongoing research regarding the triggers of ACM, there are no specific guidelines on how to prevent them.
However, topiramate and sodium valproate are two medications that may
Additionally, the antihypertensive medication propranolol may
Epilepsy is a condition in which a person experiences seizures.
According to a
These conditions share some similarities, including similar:
- cognitive dysfunction, which is when a person has difficulty remembering
- clinical features, such as lethargy
- risk factors and incidence rates
Migraine can also occur alongside epilepsy.
The symptoms of ACM can mimic a focal unaware seizure. A person experiencing either an ACM episode or the aftermath of a focal unaware seizure may:
- have a headache
- feel tired
- feel unwell
- feel confused
- not remember what happened
However, during a seizure, a person may experience shaking, stiffened muscles, and fumbling or chewing motions.
Additionally, the duration of each seizure differs. Seizures last approximately 2 minutes, whereas ACM episodes last up to
ACM is a rare condition that requires further research to develop new medications and treatments.
New medications and treatments to help treat and prevent ACM episodes are on the horizon. One example is neuromodulation, a procedure that stimulates the nervous system through the skin, similar to
Doctors see the benefits of multilayered treatments as well as the connection between the mind and body. Prescriptions are beginning to include holistic and alternative therapies to treat migraine.
If a person experiences an ACM episode, they should contact a doctor. This is because the symptoms can appear similar to other conditions,
Contacting a doctor is also important if ACM episodes:
- occur more often
- produce more intense symptoms
- continue after taking medication or therapy
- interfere with school or home activities
- prevent good sleep
ACM is a rare type of migraine that mainly affects children and teenagers. It causes symptoms such as:
- speech problems
- extreme fatigue
Although there are no specific guidelines for the treatment and prevention of ACM episodes, healthcare professionals can prescribe topiramate, sodium valproate, or propranolol.
People should speak with a doctor soon after experiencing symptoms of ACM or anytime there is a change in symptoms or symptom intensity.
Finally, anyone wanting more information on ACM should not hesitate to seek guidance from a doctor.