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Query: UMLS:C0009676 (confusion)
 21,692 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 49-year-old woman subject to frequent migraine attacks since childhood was seen for repeated episodes of confusion followed by loss of consciousness lasting for several hours. EEG during the acute stages showed marked slowing with bifrontal monorhythmic delta waves. After each episode, both the clinical and EEG findings subsided within hours. A similar course is described in a man who died at the age of 69 after preterminal mental deterioration. Autopsy showed evidence of bilateral damage to the hippocampal regions, apparently due to frequent impairment of perfusion in the last years of life. Atherosclerotic changes were within the normal range for his age. In both cases, the ischemic episodes are interpreted as consequences of constriction of the basilar artery, and it is assumed that the underlying mechanism is at least akin to that of migraine.
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PMID:[Recurring loss of conciousness with middle brain symptoms in migraine]. 43 79

Children with migraine, or, less commonly, with no previous history of migraine, may have agitated confusion lasting from several minutes to hours. There is a tendency for the confusional attacks to recur, but they are eventually replaced by typical migraine. The natural history of this syndrome with 1 1/2 to 5 years' follow-up in five children is reported. The mechanism is believed to be cerebral ischemia of one or both hemispheres.
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PMID:The natural history of acute confusional migraine. 65 10

All memory disturbances, especially those developing suddenly, cause anxiety of the patient. Transient global amnesia is a form of amnesia of interest in many aspects. The amnesia was described in 1964 by Fisher and Adams, and as yet about 1000 cases have been reported. Middle aged or elderly patients prevail. The attack of amnesia lasts from several to about 20 hours and begins suddenly being regarded as mental confusion. The amnesia covers recent and remote events in many years. During the attack the patient is not appearing to be ill, but is depressed not knowing what has happened. The awareness of own personality, the ability to solve logical problems and visuospatial functions are preserved. The ability to execute complex activities, e.g. car driving, is normal. The aetiology of the disorder is completely unknown. The hypotheses for explaining the syndrome are: 1. ischaemia in the posterior cerebral arteries region with transient fall of blood supply through the vertebrobasilar system, 2. epilepsy or migraine, 3. disturbed aggregation of platelets in the cerebral vessels leading to loss of vessel patency. The first hypothesis seems least plausible. Attacks of this amnesia were noted after triazolam, after thalamic infarction and cerebral angiography, in brain tumours, hydrocephalus, scleroderma, frontal lobe haemorrhage. After an attack the events occurring in it are not remembered. Recurrence of attacks is very rare. Most authors consider that the disorder is benign and regresses without sequelae or only with slight changes in cognitive functions and memory fixation.
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PMID:[Transient global amnesia. Case report]. 130 17

Acute confusional state (ACS) as a manifestation of migraine in the pediatric age group was initially described by Gascon and Barlow. The characteristics and natural history of acute confusional migraine (ACM) have been elaborated on by other authors. The diagnosis of ACM is, however, easily overlooked in clinical practice, due to its peculiar presentation. We describe three children who had acute onset of confusion. The differential diagnosis of acute confusional state and the clinical features and management of ACM are discussed.
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PMID:Acute confusional migraine: case series and review of literature. 161 98

A prospective study of the neurological manifestations in all patients with systemic lupus erythematous (SLE) was conducted between February 1985 to January 1989. Excluding herpes zoster infection of peripheral or cranial nerves, post-herpetic neuralgia and migraine, 36 neurological episodes occurred in 33 patients. The presenting symptoms were mental confusion (10), psychosis (five), seizures (six), focal neurological deficit (three), coma (two), headache (five), blurring of vision (three), neuropathy (one) and myelopathy (one). Of these manifestations, only eight episodes were due to primary involvement by SLE: psychosis (two), seizure (two), multiple cerebral infarcts (one), papillitis (one), neuropathy (one) and myelopathy (one). Infection was the most common secondary cause of neurological episodes: all 10 episodes of mental confusion (fungal seven, pyogenic two, tuberculous one, nocardial one); two of six seizures (tuberculous one, pyogenic one); all five headaches (tuberculous meningitis three, cryptococcal meningitis two). The other secondary causes included steroid psychosis (two), hypertensive encephalopathy with seizure (one) and hypertensive retinopathy (one). Three of five cases of focal neurological deficit were due to macrovascular disease rather than to vasculitic infarction. We concluded that cerebral psychosis was a relatively rare presentation in our patients with SLE. In patients who presented with a neurological problem, especially mental confusion, efforts should be made to ascertain the underlying cause, especially if this may be an infection.
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PMID:Neurological manifestations of systemic lupus erythematosus: a prospective study. 180 Oct 58

Migraine in children is diagnosed in presence of paroxystic episodes of headache which recur with free intervals, provided intracranial diseases are excluded. Pathogenesis of this disorder is unclear; migraine with and migraine without aura may be different entities. Many factors can precipitate a migraine attack. In school age, psychologic stress is the commonest factor. Main characteristics of attacks in children are headache, which may be hemicranial; nausea and vomiting, abdominal pain, paraesthesiae. Scotomata are not very common in the pediatric age. In some cases, migraine attacks are complicated by sensory or motor symptoms (paraesthesiae, paresis), usually at one hemisoma. In the basilar artery migraine syndrome, features of brain-stem dysfunction predominate. In a few patients a migraine attack presents itself as an acute confusional state. In migraine, EEG abnormalities are frequent (predominance of diffuse or focal slowing). In some cases a CSF pleocytosis is found after an attack of complex migraine. Prognosis is good. Preventive treatment is necessary if the attacks are severe and if they cannot be relieved by rest or sleep. Symptomatic headaches may be produced by a variety of causes. Rarely, it is secondary to increased intracranial pressure. In the great majority of cases recurrent headache is due to migraine. Usually, clinical data are sufficient for diagnosis, though in some cases the diagnosis is difficult and it is necessary to perform laboratory examinations in order to exclude symptomatic headache.
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PMID:Headache in childhood. 266 55

Acute confusional state (ACS) relates to a sudden alteration of the mental status. The impairment may be global or confined to a specific faculty of higher cortical function. Such specificity does not depend on the nature of the pathological process, but rather on the anatomical location of the area of the brain which is involved. In the absence of relevant medical history and associated signs and symptoms, the differential diagnosis of ACS may be difficult. Two case reports of unusual causes of ACS are presented: basilar migraine manifesting as transient global amnesia, and absence status. These are followed by a brief review of etiological causes of ACS commonly encountered in the pediatric practice, and a more detailed review of rare causes, such as non-convulsive epilepsy and migraine. A list of auxiliary tests for cases which are not readily diagnosed is presented.
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PMID:Acute confusional state in childhood. 307 72

The history of a girl is described who experienced two separate episodes of acute confusion with agitation. The first occurred at the age of four after a mild head injury, the second recently at the age of thirteen after prolonged physical effort. EEG's performed during both episodes showed marked diffuse slowing. Both clinical picture and EEG normalized rapidly. Clinical features and prompt recovery made the diagnosis 'acute confusional migraine' most likely. The relevant literature and importance of recognizing the syndrome are discussed
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PMID:Acute confusional migraine. Case report and review of literature. 319 58

There is some suggestion in the literature that patients with migraine may be at an increased risk for developing complications as a result of cerebral angiography. To assess this risk, we reviewed the charts of 142 patients with migraine. A total of 149 angiograms were performed for acute headache (55), new focal symptoms (40), exertional (including coital) headaches (nine), hemiplegic migraine (three), ophthalmoplegic migraine (five), vertebrobasilar migraine (six), migraine accompaniments (three), and other causes (14). Transient events were seen in six patients and these were transient amnesia (one), hemisensory changes (two), hemiparesis (one), global confusion (one), and angina (one). One patient with a history of severe ischemic heart disease developed a myocardial infarction two hours after angiography. Focal cerebral events occurred in 2.6% of cases. This compares with a rate of complications of 2.8% caused by angiography in a prospective study of 1002 patients from our center. According to our findings, it appears that a history of migraine does not increase the risk of complications caused by angiography. Angiography during episodes of acute headaches would also appear to be a safe procedure. Transient focal neurologic symptoms, however, are not infrequent, especially in cases of classic migraine.
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PMID:Migraine and the risks from angiography. 339 65

Twelve patients with episodes of acute confusional migraine (ACM) are reported. Prolonged agitation and mental confusion characterized the headache attacks, occurring mostly among adolescents. The ictal EEG showed diffuse, slow abnormalities and a peculiar pattern known as FIRDA (frontal intermittent rhythmic delta activity). Neuroradiologic examinations and laboratory tests were unremarkable. After the acute stage, EEG gradually tended to show normalization. Apart from the noticeable similarities to the "juvenile head trauma syndrome", the authors assume that ACM represents a peculiar clinical form among the different types of migraine associated with disorders of higher mental functions.
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PMID:Acute confusional migraine: clinical and electroencephalographic aspects. 358 Nov 59


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