구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)

  • 제33권1호
  • /
  • Pages.1-6
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  • 2017
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  • 2384-4353(pISSN)
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  • 2384-4272(eISSN)
대한턱관절교합학회 (Korean Academy of Stomatognathic Function and Occlusion)
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만성편두통 치료를 위한 측두 부위의 보툴리눔 독소 주사 자입점 제시

A proposal of injection points of botulinum toxin into temporal region for chronic migraine

  • 김영건 (연세대학교 치과대학 구강내과학교실, 해부학교실) ;
  • 배정희 (연세대학교 치과대학 구강내과학교실, 해부학교실) ;
  • 김성택 (연세대학교 치과대학 구강내과학교실, 해부학교실)
  • Kim, Young Gun (Department of Orofacial Pain and Oral Medicine, Department of Anatomy, College of Dentistry, Yonsei University) ;
  • Bae, Jung Hee (Department of Orofacial Pain and Oral Medicine, Department of Anatomy, College of Dentistry, Yonsei University) ;
  • Kim, Seong Taek (Department of Orofacial Pain and Oral Medicine, Department of Anatomy, College of Dentistry, Yonsei University)
  • 투고 : 2017.02.01
  • 심사 : 2017.03.15
  • 발행 : 2017.03.31
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초록

보툴리눔 독소 주사는 이마, 눈가 주름치료 등 미용성형분야 뿐만 아니라 만성 편두통(chronic migraine), 근육긴장이상(dystonia), 경직(spasticity), 측두하악장애의 치료 등에 사용되어 왔다. 특히 보툴리눔 독소 주사는 만성편두통환자의 예방적 치료요법으로 현재까지 유일하게 승인된 요법이다. 기존에 잘 알려진 운동신경에서의 마비효과와는 달리, 편두통에 대한 작용기전은 감각신경에서 말초감작과 신경원성염증과 관련되는 substance P, CGRP, glutamate 등 비콜린성 신경전달물질의 유리를 차단하여 통증신호를 차단하는 역할을 한다는 가설이 제기되고 있다. 본 논문에서는 보툴리눔독소가 갖는 진통효과에 대한 고찰과 함께 이를 통하여 추후 만성편두통환자에 대한 주사법 개발에 대한 방향성을 제시하고자 한다.

Botulinum toxin (BoNT) injections have been used not only in the field of cosmetic surgery such as forehead and eye wrinkle treatment but also in the treatment of chronic migraine, dystonia, spasticity, temporomandibular disorders (TMD). BoNT injections are the only approved therapies to date for prophylactic treatment of chronic migraine patients. Unlike the previously known paralysis of motor neurons, the mechanism of action for migraine is to block the release of non-cholinergic neurotransmitters such as substance P, CGRP, and glutamate, which are associated with peripheral sensitization and neurogenic inflammation in the sensory nerve, it is hypothesized that the signal is blocked. This review focuses on the analgesic effects of BoNT and suggests the direction for the development of injection methods for chronic migraine patients.

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참고문헌

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