Introduction: Acute confusional migraine is a transient confusional state, and in some cases headache is not present. It is a rare manifestation, with few cases in the literature, most of them in adolescence.

Clinical cases: We report 3 cases in adolescents with this pathology, one of them with past medical history of migraine. The first one presented a slowed interictal electroencephalogram that merited initiating intravenous acyclovir, although it limited the clinic with intravenous haloperidol; the second one presented a loss of consciousness and prolonged hypotonia, and the last one was in previous follow-up due to migraine without prophylaxis. Magnetic resonance image was normal in all of them. The follow up of our patients was good, with full recovery and without new confusional episodes.

Conclusion: Acute confusional migraine is a rare entity that needs to be known to study it in the differential diagnosis of acute confusional symptoms. There are few published cases, so the therapeutic experience is scarce and controversial. New series with larger sample size could suggest the most suitable treatments and help to better understand the evolution of these patients.

Introduction: Transient global amnesia (TGA) is a clinical condition characterized by sudden loss of anterograde memory and a varying degree of retrogade amnesia. Immediate memory is preserved and the neurological examination is normal. The memory deficit resolves within a few hours. This condition is frequent in middle-aged or elderly patients.

Case report: A 9-year-old girl developed sudden anterograde amnesia with preserved immediate memory and a certain degree of retrogade memory deficit, associated with a mild headache. The neurological examination was normal. The clinical condition resolved spontaneously in 4 hours. The patient was left with a mild headache and no memory of the attack. As the brain computed tomographic (CT) scan was normal, the clinical condition suggested a case of TGA.

Discussion: The clinical features reported here are characteristic of TGA. This neurological disorder appears spontaneously, but several precipitating factors may exist. The pathogenetic hypotheses include a vascular etiology with transient vertebrobasilar ischemia, an epileptic phenomenon or a migraine-related event. Acute confusional migraine, typical of childhood, presents with clinical manifestations similar to TGA. The diagnosis of this process is based on clinical findings. It has an excellent prognosis and little tendency to recur. Given the fact that TGA is not frequent in childhood, we performed a CT scan to rule out the possibility of a cerebral ischemic attack. The presence of the typical clinical symptoms and a normal neuroimaging study should lead us to consider this diagnosis in childhood as well.