• The Korean Journal of Pain
• /
• 제18권1호
• /
• pp.29-33
• /
• 2005

Background: Chronic headache (CH) constitutes a significant public health problem, impacting on both the individual sufferer and society. Patients with CH, unresponsive to drug therapy or nerve block, suffer considerable disability due to the frequency and severity of attacks; therefore, they should be considered for novel therapy. Botulinum toxin type A (BoNT-A) has shown significant promise in the management of CH. In this paper, we review recent evidence on the efficacy of BoNT-A, and also report our experience with this treatment in CH patients. Methods: BoNT-A was used to treat 69 CH patients, including 47 in a chronic migraine group and 22 in a non-migraine CH group, who showed therapy-resistance to palliative drug or nerve block. We investigated the demography, dosage and site of BoNT-A injection, and used a visual analogue scale (VAS) for pain and the degree of satisfaction. The data were analyzed using t-tests and a Friedman repeated measures analysis of variance on ranks. Results: Significant decreases in the VAS for pain were found in both the chronic migraine and non-migraine CH groups, from 2, 4 and 12 weeks and from 4 and 12 weeks, respectively, after BoNT-A administration (P < 0.05). The chronic migraine group showed significantly lower VAS scores for pain than the non-migraine CH group from 2, 4 and 12 weeks after the BoNT-A administration (P < 0.05). Twenty eight patients (59.2%) in the chronic migraine group and eight (36.4%) in the non-migraine CH were satisfied with the BoNT-A treatment. Conclusions: This clinical study revealed that the use of BoNT-A demonstrated efficacy for CH patients resistant to drug therapy or nerve block. Moreover, BoNT-A proved itself more effective in the chronic migraine than non-migraine CH group.

• The Korean Journal of Pain
• /
• 제35권1호
• /
• pp.4-13
• /
• 2022

Changes in diagnostic criteria, for example, the various International Classification of Headache Disorders criteria, would lead to changes in the outcomes of epidemiological studies. International Classification of Headache Disorders-1 was based mainly on expert opinion, yet most of the diagnostic criteria were reliable and valid, but it did not include chronic migraine. In its second version, the classification introduced chronic migraine, but this diagnosis resembled more a high-frequency migraine rather than the actual migraine transformation process. It also introduced medication overuse headache, but it necessitated analgesic withdrawal and subsequent headache improvement to be diagnosed as such. Hence patients having medication overuse headache could only be diagnosed in retrospect, which was an awkward situation. Such restrictive criteria for chronic migraine and medication overuse headache omitted a high proportion of patients. International Classification of Headache Disorders-3 allows a diagnosis of medication overuse headache due to combination analgesics if taken for at least 10 days per month for more than three months. Hence the prevalence rate of medication overuse headache and chronic migraine can increase compared to the previous version of the headache classification. Different criteria have been used across studies to identify chronic migraine and medication overuse headache, and therefore the information acquired from previous studies using earlier criteria becomes uncertain. Hence much epidemiological research would need to be interpreted cautiously or repeated with the most updated criteria, since the subjects in studies that apply the latest criteria may be phenotypically different from those in older studies.

• 대한한의학회지
• /
• 제44권3호
• /
• pp.140-149
• /
• 2023

Objectives: This case report aims to describe the effects of craniosacral therapy and acupuncture in a patient with chronic migraine. Methods: A 33-year-old man with chronic migraine was treated with 20 sessions of craniosacral therapy and acupuncture for 8 weeks. The number of migraine and headache days were monitored every month. The pain intensity of headache was measured on the visual analog scale (VAS). Korean Headache Impact Test-6 (HIT-6) and Migraine Specific Quality of Life (MSQoL) were also used. Results: The number of headache days per month reduced from 28 to 7 after 8 weeks of treatment and to 3 after 3 months of treatment. The pain intensity of headache based on VAS reduced from 7.5 to 3 after 8 weeks and further to < 1 after 3 months of treatment. Furthermore, the patient's HIT-6 and MSQoL scores improved during the treatment period, which was maintained or further improved at the 3 month follow-up. No side effects were observed during or after the treatment. Conclusion: This case indicates that craniosacral therapy and acupuncture could be effective treatments for chronic migraine. Further studies are required to validate the efficacy of craniosacral therapy for chronic migraine.

• 구강회복응용과학지
• /
• 제33권1호
• /
• pp.1-6
• /
• 2017

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.

• 대한한방내과학회지
• /
• 제39권4호
• /
• pp.784-793
• /
• 2018

Objective: Chronic migraine is a headache syndrome accompanied by nausea, dyspepsia, depression, and insomnia and it reduces the quality of life. The present case revealed that Korean medicine treatment and Functional Cerebrospinal Therapy (FCST) can reduce headache and nausea in patients with chronic migraine. Method: A 39-year-old female patient with chronic migraine visited Dunsan Korean Medicine Hospital. She had headache combined with moderate nausea and wanted to reduce her dose of almotriptan. We treated her with Korean medicine, including acupuncture, herbal medicine, and a Chuna treatment based on FCST. We evaluated her symptoms using a Numeric Rating Scale (NRS) for headache and nausea every day. Result: After 22 days of treatment, the NRS of headache and nausea had reduced. Her dose of almotriptan was also reduced and the patient felt improvement of in her quality of life. Conclusion: We suggest that Korean medicine treatment combined with FCST can improve the headache and nausea of chronic migraine patients.

• 대한한방내과학회지
• /
• 제39권2호
• /
• pp.154-158
• /
• 2018

Introduction: This case report assessed the effects of Korean medicine treatments on a chronic migraine patient who did not respond to triptan. Case Presentation: The patient received Korean medicine treatments, such as acupuncture, moxibustion, cupping, and herbal medication, during a hospitalization period. The effects of treatments were assessed with the Numerical Rating Scale (NRS) and migraine attack frequency. The intensity and attack frequency of migraines were significantly reduced after the complete treatment. Conclusions: For migraines, Korean medicine such as acupuncture and herbal medication could be an alternative to conventional therapy.

• 동의생리병리학회지
• /
• 제22권6호
• /
• pp.1594-1599
• /
• 2008

Migraine is a very common unilateral and throbbing headache, and a chronic relapsing and remitting disorder characterised by neurological, gastrointestinal, and autonomic changes. It has a high prevalence, often recurs at the time of being in full activity of life, and has a serious impact on patients personally and socially. So we need to develop a oriental medicine for migraine. I have treated two migraine patients using Zhuapiandutongbang (Zuopiantoutongfang) of Dongyibogam. The impression of first case is migraine with aura, and that of second case is probable migraine. We just give Zhuapiandutongbang (Zuopiantoutongfang)'s medicine to two patients, but don't apply acupucture and anything to treat. We reported that Zhuapiandutongbang (Zuopiantoutongfang) has a good effect on not only the improvement of symptoms but also the prevention of relapse.

• The Korean Journal of Pain
• /
• 제36권1호
• /
• pp.137-246
• /
• 2023

Background: To investigate the relationship between cutaneous allodynia (CA) and kinesiophobia, gastrointestinal system (GIS) symptom severity, physical activity, and disability, and to determine whether CA, pain, and disability were influencing factors for kinesiophobia, GIS symptoms, and physical activity in individuals with migraine. Methods: The study included 144 individuals with migraine. CA, kinesiophobia, GIS symptoms, physical activity level, and migraine-related disability were evaluated with the Allodynia Symptom Checklist, the Tampa Kinesiophobia Scale (TKS), the Gastrointestinal Symptom Rating Scale (GSRS), the International Physical Activity Questionnaire-7, and the Migraine Disability Assessment Scale (MIDAS), respectively. Results: The CA severity was only associated with TKS (r = 0.515; P < 0.001), GSRS-total (r = 0.336; P < 0.001), GSRS-abdominal pain (r = 0.323; P < 0.001), GSRS-indigestion (r = 0.257; P = 0.002), GSRS-constipation (r = 0.371; P < 0.001), and MIDAS scores (r = 0.178; P = 0.033). Attack frequency (P = 0.015), attack duration (P = 0.035) and presence of CA (P < 0.001) were risk factors for kinesiophobia. Attack frequency (P = 0.027) and presence of CA (P = 0.004) were risk factors for GIS symptoms. Conclusions: There was a relationship between the CA and kinesiophobia, GIS symptoms, and disability. CA and attack frequency were found to be risk factors for kinesiophobia and GIS symptoms. Migraine patients with CA should be assessed in terms of kinesiophobia, GIS, and disability. Lifestyle changes such as exercise and dietary changes and/or pharmacological treatment options for CA may increase success in migraine management.

• Investigative Magnetic Resonance Imaging
• /
• 제21권3호
• /
• pp.192-194
• /
• 2017

Giant arachnoid granulations have been reported to be associated with headaches, which can be acute or chronic in presentation. In some cases, idiopathic intracranial hypertension, previously called pseudotumor cerebri, may occur. The pathophysiology of these enlarged structures seen as filling defects on imaging is not clearly defined, although they are presumed to cause symptoms such as headache via pressure resulting from secondary venous sinus obstruction. We present a unique presentation of secondary headache in a 39-year-old man with no prior history of headaches found to have giant arachnoid granulations, presenting as migraine with aura.

• 한국임상약학회지
• /
• 제29권2호
• /
• pp.71-78
• /
• 2019

Objective: This study aimed to provide efficacy and safety information on the use of erenumab for prevention of episodic and chronic migraines. Methods: The keywords "Erenumab and migraine" were used to search the PubMed database to then compile efficacy and safety data for erenumab. Data from relevant Phase 2 and Phase 3 clinical trials were analyzed, using RevMan for statistical analysis. Results: Three clinical trials (one Phase 2 and two Phase 3 studies) were retrieved. All three trials used the same primary endpoint (change from baseline in monthly migraine days (CBMD)) to evaluate efficacy and safety of erenumab use for prevention of episodic and chronic migraines. Subcutaneous doses of erenumab (70 or 140 mg) were administered monthly in each trial, for 3 months (Studies 2, and 3) or 6 months (Study 1). The mean differences in CBMD in the 70 mg and 140 mg erenumab arms were -1.36 and -1.98, respectively, compared to that in the placebo arm. Some adverse events, such as nasopharyngitis and upper respiratory tract infection, were reported, but no differences in safety between erenumab and placebo were found to be significant. Conclusions: Erenumab showed superior efficacy in prevention of migraines compared to placebo. However, additional information regarding the long-term safety of erenumab should be collected. Therefore, post-marketing surveillance for adverse events is needed.