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Scholarly Commons > HCA Healthcare Journal > Vol. 6 > Iss. 3 (2025)

 

Keywords

acute confusional migraine; psychosis; neuropsychological conditions; atypical migraine; complex migraine; migraine disorders; confusion

Disciplines

Neurology | Psychiatric and Mental Health | Psychiatry

Abstract

Background

Migraine affects about 1 billion people worldwide and is associated with a significant negative impact on personal and occupational functioning. Migraine accompanied by aura is seen in about 15% of migraineurs. Visual aura is the most common type of aura. Much less common though are auras that involve higher mental function, such as confusional state. The confusional state may manifest with a wide variety of cortical dysfunction, such as speech impairment, increased alertness, agitation, and amnesia, often lasting longer than a typical migraine aura.

Case Presentation

The authors present the unique case of a 29-year-old patient with episodic and transient bizarre behavioral symptoms in the context of migraine headaches.

Conclusion

Our patient’s presentation is suggestive of acute confusional migraine, which poses several diagnostic complexities and illustrates the difficulties with symptomatology that might have a medical/organic component versus a psychiatric one. The literature on this topic is lacking, and further research into this condition is warranted to optimize comprehensive patient care.

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