Acute Confusional Migraine in an Adolescent: Response to Intravenous Valproate

Avraham, Shabtai; Har-Gil, Miki; Watemberg, Nathan

doi:10.1542/peds.2009-2717

Cited by 18 publications

(7 citation statements)

References 17 publications

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“…Recent publications described “pediatric confusional migraine” cases in which valproate was efficacious. However, they did not investigate whether there was also photosensitivity [55, 56]. …”

Section: Role Of Photosensitivitymentioning

confidence: 99%

Headache, epilepsy and photosensitivity: how are they connected?

et al. 2010

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Although headache and epilepsy have often been associated, the precise electroclinical and pathophysiological interaction between these disorders and in particular its relations with photosensitivity is as yet to be fully understood in adults or children. The association between headache and epilepsy commonly occurs in all types of epilepsy and not only in occipital epilepsy. Generally, peri-ictal headache is often neglected, regardless of its severity, because patients are more concerned about their seizures. Altered cerebral cortex excitability may be the link between these two conditions and photosensitivity shows this. The physician should bear this association in mind when dealing with epileptic and migraine patients so as to be able to offer such patients an accurate diagnosis and appropriate treatment; this should be borne in mind when declaring epileptic patients ‘seizure free’. To date neither the International Headache Society nor the International League against Epilepsy mention that headache/migraine may, on occasion, be the sole ictal epileptic manifestation. Lastly, studies designed to investigate the triggering role of photosensitivity in both headache and epilepsy are warranted.

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Section: Role Of Photosensitivitymentioning

confidence: 99%

Headache, epilepsy and photosensitivity: how are they connected?

et al. 2010

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“…Treatment : No specific therapy was mentioned in most case reports; however, some reports suggested efficacy of sodium valproate and prochloroperazine as treatment modalities for acute confusional state [ 12 , 19 , 21 , 22 ]. Prophylactic treatment with topiramate seems to be effective in the treatment of recurrent ACM [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

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

Farooqi¹,

Padilla²,

Monteith³

2018

Brain Sciences

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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.

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“…There have been few reports in the literature regarding the treatment of ACM. Avraham et al 12 reported a case of a young girl with a first episode of ACM that was responsive to valproic acid (VPA) during the acute confusional phase and intravenous VPA was suggested as an effective drug. In one of the preliminary studies carried out, Shahein et al 13 concluded that intravenous sodium valproate was found to be safe and rapidly effective for intractable migraine attack.…”

Section: Discussionmentioning

confidence: 99%

Acute confusional migraine: a variant not to be missed

et al. 2013

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A middle age woman who had frequent migraines was admitted with memory loss following severe unilateral headache, restlessness and confusion. Investigations including haematology, biochemistry, cerebrospinal fluid analysis serology and imaging were normal. As she had frequent migraines with a history of ophthalmoplegic migraine, acute confusional migraine was thought of as a possibility. The patient responded dramatically to intravenous sodium valproate. We report this case to emphasise that acute confusional migraine, a rare variant of migraine, is occasionally encountered in adults and prompt recognition will lead to appropriate management.

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Acute Confusional Migraine in an Adolescent: Response to Intravenous Valproate

Cited by 18 publications

References 17 publications

Headache, epilepsy and photosensitivity: how are they connected?

Headache, epilepsy and photosensitivity: how are they connected?

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

Acute confusional migraine: a variant not to be missed

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