• Title/Summary/Keyword: Migraine disorder

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A Case Report on Patients of Hemiplegic Migraine (반신마비성(半身痲痺性) 편두통(偏頭痛) 환자(患者) 치험(治驗) 1예(例))

  • Yi Jae-Eun;Yi Sung-Woo;Sun Seung-Ho;Jung Yong-Soo;Kim Byung-Woo
    • The Journal of Internal Korean Medicine
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    • v.25 no.1
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    • pp.119-125
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    • 2004
  • Hemiplegic migraine is a typical symptom of general migraine. With this disorder, patients at any age can have a series of unilateral paralysis that would outlast a normal headache. It can be classified into three types, such as familiar hemiplegic migraine, sporadic hemiplegic migraine and unclassifiable hemiplegic migraine. Although it is known that normal hemiplegic migraine is associated with the gene on chromosome 19, the accurate cause and effective therapeutics have not been demonstrated yet. When a patient, subjected to this study complained unilateral hemiparesis and sensory disturbance with severe migraine and dysarthria, we thought that the direct cause of this symptoms was the stress. Therefore, we approached this disorder by focusing on the psychological aspect and finally gained a good result with Chilbok-yeum which releases the psychological irritation, so we report it for the better treatment.

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Two Cases Report of the Patients with Left Migraine Improved with Zhuapiandutongbang (좌편두통방으로 호전된 좌측 편두통 환자 치험 2례)

  • Sun, Seung-Ho
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.6
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    • pp.1594-1599
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    • 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.

Utilization of Preventive Therapy in Korean Migraine Patients

  • Kim, Yewon;Park, Susin;Kim, Eonjeong;Je, Nam Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.1
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    • pp.35-43
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    • 2021
  • Background: Migraine is a common neurological disorder that affects the quality of life and causes several health problems. Preventive migraine treatment can reduce migraine frequency, headache severity, and health care costs. This study aimed to estimate the utilization of migraine preventive therapy and associated factors in eligible patients. Methods: We studied 534 patients with migraine who were eligible for migraine preventive therapy using 2017 National Patient Sample (NPS) data from the Health Insurance Review and Assessment Service (HIRA). We estimated the migraine days by calculating the monthly average number of defined daily dose (DDD) of migraine-specific acute drug. Patients with a monthly average number of DDD of 4 or more were considered as subjects for preventive treatment. Chi-square test and multiple logistic regression analysis were used to determine the association between the preventive therapy and the influencing variables. Results: Less than half of the eligible patients for prophylaxis (n=234, 43.8%) were prescribed preventive therapy. Multiple logistic regression results show that migraine preventive therapy was influenced by age, the type of migraine, and some comorbidities. Patients over the age of 50 tend to receive less prophylactic treatment than under the age of 40. On the other hand, migraine patients with epilepsy or depression were more likely to receive preventive therapy. Sumatriptan was the most preferred medication for acute treatment, and propranolol was the most commonly prescribed drug for prevention. Conclusions: More than half of the patients who were candidates for migraine prophylaxis were not receiving suitable preventive treatment. Positive factors affecting the use of migraine prevention were the presence of comorbidities such as epilepsy and depression.

Meta-analysis on the Efficacy of Glutamate Receptor Antagonists for Acute Migraine Treatment (급성 편두통 치료를 위한 글루탐산 수용체 길항제의 임상적 유효성에 대한 메타분석)

  • Kim, Sunhee;Baek, In-hwan
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.4
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    • pp.247-253
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    • 2019
  • Background: Glutamate is implicated in the pathophysiology of migraine, a common neurological disorder. Therefore, glutamate receptor antagonists (GluRAs) have been suggested as a novel migraine treatment that are able to overcome the limitations of triptans. Objective: The aim of this study was to perform a meta-analysis to assess the efficacy of GluRAs for patients with migraine. Method: The PubMed, Cochrane Library, CINAHL, and Clinical Trial.gov databases were searched for randomized placebo-controlled trials of the efficacy of GluRAs for patients with migraine conducted up to August 2019. Two independent reviewers screened the literature according to inclusion and exclusion criteria and performed quality assessment and data extraction. Review Manager 5.3 software was used for the meta-analysis. Results: Three studies involving a total of 206 patients were included in the final analysis. Compared with placebo, GluRAs significantly improved the pain-free response at 2 hours (odds ratio [OR]=3.85, 95% confidence intervals [CIs]=1.63-9.09) and the 24-hour sustained pain freedom (OR=7.40; 95% CIs=2.36-23.20). The use of rescue medications with GluRAs was lower compared to that with placebo, but the difference was not significant (OR=0.39, 95% CI=0.10-1.47). Conclusion: Our meta-analysis showed that GluRAs were more effective than placebo for patients with migraine.

Long Term Follow-Up of Cyclic Vomiting Syndrome (주기성 구토증(cyclic vomiting syndrome)의 장기 추적 관찰 -이형 편두통(migraine variant)으로의 이행 과정인가?-)

  • Hwang, Jin-Bok;Oh, Hee-Jong;Choi, Kwang-Hae
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.75-83
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    • 2000
  • Cyclic vomiting syndrome(CVS) is a disorder of unknown etiology that is characterized by its clinical pattern of intermittent episodes of severe vomiting, similar in time of onset and duration, with no symptoms during the intervening period. By definition, CVS is an idiopathic disorder that requires exclusionary laboratory testing. Not only can it be mimicked by many specific disorders, eg, surgical, neurologic, endocrine, metabolic, renal, but within idiopathic CVS there may be specific subgroups that have different mechanisms. It has been reported that CVS usually begins in toddlers and resolves during adolescence. Migraine is also self-limiting episodic condition of children and the clinical features of migraine and CVS show considerable similarity. It is proposed that CVS is a condition related to migraine. This paper reports clinical courses of long term follow-up and reversible EEG changes in three patients whose history included CVS. Clinical situations of attack interval, duration and associated symptoms had changed variablely in each patients through long term follow-up period. Cyclic vomiting subsided in two cases. Abnormal delta activity was seen during episodes and resolved at follow-up, when the patient asymptomatic. The brain wave changes support the interpretation of CVS as a migraine variant.

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Effect of carbamazepine on tetrodotoxin-resistant Na+ channels in trigeminal ganglion neurons innervating to the dura

  • Han, Jin-Eon;Cho, Jin-Hwa;Nakamura, Michiko;Lee, Maan-Gee;Jang, Il-Sung
    • The Korean Journal of Physiology and Pharmacology
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    • v.22 no.6
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    • pp.649-660
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    • 2018
  • Migraine is a neurological disorder characterized by recurrent and disabling severe headaches. Although several anticonvulsant drugs that block voltagedependent $Na^+$ channels are widely used for migraine, far less is known about the therapeutic actions of carbamazepine on migraine. In the present study, therefore, we characterized the effects of carbamazepine on tetrodotoxin-resistant (TTX-R) $Na^+$ channels in acutely isolated rat dural afferent neurons, which were identified by the fluorescent dye DiI. The TTX-R $Na^+$ currents were measured in medium-sized DiIpositive neurons using the whole-cell patch clamp technique in the voltage-clamp mode. While carbamazepine had little effect on the peak amplitude of transient $Na^+$ currents, it strongly inhibited steady-state currents of transient as well as persistent $Na^+$ currents in a concentration-dependent manner. Carbamazepine had only minor effects on the voltage-activation relationship, the voltage-inactivation relationship, and the use-dependent inhibition of TTX-R $Na^+$ channels. However, carbamazepine changed the inactivation kinetics of TTX-R $Na^+$ channels, significantly accelerating the development of inactivation and delaying the recovery from inactivation. In the current-clamp mode, carbamazepine decreased the number of action potentials without changing the action potential threshold. Given that the sensitization of dural afferent neurons by inflammatory mediators triggers acute migraine headaches and that inflammatory mediators potentiate TTX-R $Na^+$ currents, the present results suggest that carbamazepine may be useful for the treatment of migraine headaches.

Biofeedback Treatment for Tension-Type Headache and Migraine (긴장성두통과 편두통의 바이오피드백 치료)

  • Park, Joo-Eon;Lee, Kye-Seong;Shin, Sang-Eun
    • Korean Journal of Psychosomatic Medicine
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    • v.14 no.1
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    • pp.25-32
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    • 2006
  • Objectives : Headache is a clinical symptom that more than 90% of all individuals experience during their life time. This article provides a current concept of tension-type and migraine headaches and summarizes the effects of biofeedback treatment and/or relaxation techniques. Methods : The following terms were used for Pubmed/Medline search : biofeedback, relaxation, physiological, behavioral, nonpharmacological, headache, tension-type headache, and migraine. A review of references from relevant literature was also conducted to collect reports not identified in the Pubmed/Medline search. Interviews with experts on biofeedback were also included in this review. Results : Headache is a psychophysiological symptom that can be treated by some behavioral interventions including biofeedback and relaxation. Literatures on biofeedback and/or relaxation have consistently reported significant therapeutic effects on headaches. Important factors that we have to consider, when we apply to headache patients with biofeedback and relaxation techniques, were also presented. Conclusion : The available evidence suggests that biofeedback and relaxation techniques are effective treatments for the patients with headaches and can be provided to the patients as monotherapy or combination therapy with medication.

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Simultaneous Heat-Massage Therapy for Migraine Without Aura : A Case Report (무전조성 편두통 환자에서 온열과 마사지 동시 치료의 효과: 증례보고)

  • Lee, Kwang-Jae;Yoon, Yong-Soon
    • Journal of Digital Convergence
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    • v.18 no.8
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    • pp.505-509
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    • 2020
  • A migraine was a headache disorder characterized by recurrent moderate to severe headaches. The diagnosis was based on clinical signs and symptoms. Medication, physical therapy, nerve block, and nerve stimulation could be applied for treatment. This report described a case of severe migraine without aura that lasted several weeks periodically in a 59-year-old woman. Periodic headache had lasted for more than 14 years, and although she took medicines and nerve blocks, severe pain (VAS 7) was persisted. We recommended her to use the thermo-spinal massage device (CGM MB-1401, CERAGEM Inc., Cheonan, South Korea) continuously three times a week applying in semi-automatic mode around the neck for 40 minutes. There was no change in the pain scale in the automatic mode for the first 4 weeks. Subsequently, the semi-automatic mode of the cervical area was treated for 2 weeks to relieve the pain scale, and it was confirmed that the relieved state maintained for 2 months. This case highlighted the importance in considering thermo-spinal massage devices for managing migraine without aura.

Cyclic Vomiting Syndrome: A Functional Disorder

  • Kaul, Ajay;Kaul, Kanwar K.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.4
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    • pp.224-229
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    • 2015
  • Cyclic vomiting syndrome (CVS) is a functional disorder characterized by stereotypical episodes of intense vomiting separated by weeks to months. Although it can occur at any age, the most common age at presentation is 3-7 years. There is no gender predominance. The precise pathophysiology of CVS is not known but a strong association with migraine headaches, in the patient as well as the mother indicates that it may represent a mitochondriopathy. Studies have also suggested the role of an underlying autonomic neuropathy involving the sympathetic nervous system in its pathogenesis. CVS has known triggers in many individuals and avoiding these triggers can help prevent the onset of the episodes. It typically presents in four phases: a prodrome, vomiting phase, recovery phase and an asymptomatic phase until the next episode. Complications such as dehydration and hematemesis from Mallory Wise tear of the esophageal mucosa may occur in more severe cases. Blood and urine tests and abdominal imaging may be indicated depending upon the severity of symptoms. Brain magnetic resonance imaging and upper gastrointestinal endoscopy may also be indicated in certain circumstances. Management of an episode after it has started ('abortive treatment') includes keeping the patient in a dark and quiet room, intravenous hydration, ondansetron, sumatriptan, clonidine, and benzodiazepines. Prophylactic treatment includes cyproheptadine, propranolol and amitriptyline. No mortality has been reported as a direct result of CVS and many children outgrow it over time. A subset may develop other functional disorders like irritable bowel syndrome and migraine headaches.

Pharmacological Treatments of Headache (두통의 약물학적 치료)

  • Na, Eun-Jin;Park, Jong-Il;Yang, Jong-Chul
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.20-27
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    • 2016
  • Headache is one of the most common physical symptoms which almost everyone experience at least once during a life. Headache is often associated with disability, but rarely with secondary headache which could result in a serious life-threatening illness, i.e. brain tumor. However, in most cases, headache is a benign illness which comprises a primary headache, i.e. migraine or tension-type headache. The accurate diagnosis of headache is critical for clinicians and it begins with history taking and physical examination since there are no diagnostic tests for primary headaches. Nowadays, there are a wide variety of pharmacological treatments according to each headache disorder. The specific purposes of this review are introducing history of classification of headache disorder and presenting diagnostic process of headache disorder. Then, we discuss the effective pharmacological treatment strategies of each headache disorder.