'Possessed': acute confusional migraine in an adolescent, prevented by topiramate.
Acute confusional migraine (ACM) is recognized as a rare, but highly disabling migraine equivalent, mostly reported in children and adolescents. Herein we describe the case of a 12-year-old girl admitted to hospital for an acute confusional state and severe psychomotor agitation, associated with a pulsating headache and nausea, which turned out to be a manifestation of ACM. The girl was discharged on topiramate prophylaxis, titrated up to 75 mg/die; no recurrence of confusional and/or headache episodes has been reported over the last 14 months to date. Due to the rarity of this clinical entity, only anecdotal reports about acute and prophylactic treatment of ACM are available in the literature. The case reported herein suggests that topiramate seems to be effective in ACM prophylaxis, although a longer observation period in our patient and more cases are needed to confirm any long-term clinical benefit.
Department of Neurology, Guglielmo da Saliceto Hospital, Piacenza, Italy.
Eugenia
E
Rota
Nicola
N
Morelli
Paolo
P
Immovilli
Paola De
PD
Mitri
Fabiola
F
Magnifico
Emilio
E
Terlizzi
Lucia
L
Mazza
Barbara
B
Sala
Giacomo
G
Biasucci
Donata
D
Guidetti
Acute confusional migraine; Migraine; Migraine prophylaxis; Topiramate