In some patients, an organic mental syndrome can be part of a migraine attack (Davidoff, 1995). In other patients, an acute psychotic condition is the dominating clinical feature. ... In addition, psychosocial stress is the most common precipitating factor for a migraine attack (Davidoff, 1995). Clinicians are often confused by presentations of acute confusional migraine (ACM), a rare variant of migraine headache that manifests in symptoms of confusion, agitation, disorientation, altered mental status, and problems with speech and memory. The main problem faced in ACM is the heterogeneity of symptoms.