Acute confusional migraine is a rare migraine variant primarily seen in childhood that lacks standardized diagnostic criteria. Acute symptomatic treatment for this disorder has not been established. We report 2 patients having a total of 6 episodes of acute confusional migraine where the symptoms resolved with prochlorperazine with variable success. Intravenous prochlorperazine was highly effective in 3 out of 4 episodes.