• 대한한방내과학회지
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• 제25권1호
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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.

• 동의생리병리학회지
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• 제22권6호
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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.

• 한국임상약학회지
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• 제31권1호
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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.

• 한국임상약학회지
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• 제29권4호
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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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제3권1호
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• pp.75-83
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• 2000

저자들은 주기성 구토증으로 진단된 3명의 소아에서 6년 이상의 장기 추적관찰을 통하여 임상양상의 다양한 변화과정을 관찰하여 보고, 뇌파검사의 이상소견을 근거로 이형 편두통의 형태로 진행하여 가는 과정을 관찰하였다. 시간의 경과에 따라 구토 발병 주기, 기간의 변화와 함께 위배출능 저하, 두통의 발현, 뇌파의 이상 등 다양한 임상 양상의 변화를 보여주며, 2례에서는 증상의 소실이 관찰되었다. 특히, 뇌파 검사상 증상 발현시 발생하는 서파는 편두통의 발생 직전에 뇌혈류의 감소로 발생하는 양상과 매우 유사하며, 주기성 구토증과 편두통의 관련성을 시사하여 주는 소견으로, 진단 및 치료적 접근시 반드시 고려하여야 한다. 주기성 구통증은 이형 편두통으로의 이행 과정인가?

• The Korean Journal of Physiology and Pharmacology
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• 제22권6호
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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.

• 정신신체의학
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• 제14권1호
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• pp.25-32
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• 2006

연구목적 : 두통은 일생 동안 90% 이상의 사람들이 경험하게 되는 임상 증후군이다. 이 논문은 긴장성두통과 편두통의 현재의 개념과 바이오피드백 치료 및 이완요법에 대해 요약하였다. 방법: Pubmed/Medline 검색에 포함된 용어는 바이오피드백(biofeedback), 이완(relaxation), 생리적(physiological), 행동적 (behavioral), 비약물의 (nonpharmacological), 두통(headache), 긴장성두통(tension-type headache), 그리고 편두통(migraine)이었다. 검색되지 않은 저술 중 적절한 논문과 바이오피드백을 수행하는 전문가의 의견도 포함시켰다. 결과 : 두통은 바이오피드백 및 이완요법을 포함한 행동치료적 개입에 의해 치료될 수 있는 정신생리장애(psycho-physiological disorder)로 볼 수 있다. 두통에서 이러한 치료들을 통해 임상적 호전을 보인다는 보고들이 지속되고 있다. 또한, 환자에게 실제 적용 시 고려할 점도 제시하였다. 결론: 바이오피드백 치료와 이완요법은 단독 또는 약물치료와 함께 두통 환자에게 제공될 수 있는 효과적인 치료법으로 제안된다.

• 디지털융복합연구
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• 제18권8호
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• pp.505-509
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• 2020

편두통은 중등도 내지 중증의 두통이 재발하는 것을 특징으로 하는 두통 장애이다. 진단은 임상 징후 및 증상을 기반으로 하며, 약물 치료, 물리 치료, 신경 차단 및 신경 자극이 치료에 적용될 수 있다. 이 보고서는 59세 여성의 심각한 무전조성 편두통 사례에 대한 것이다. 환자는 정기적으로 두통이 14년 이상 지속되었으며, 약과 신경 차단제를 복용했지만 심한 통증 (VAS 7)이 지속되어 왔다. 우리는 척주 온열 마사지 기기(CGM MB-1401)를 편두통 환자에게 6주간 주 3회씩 40분간 처치하였다. 최초 4주간의 자동모드에서는 통증척도에 변화가 없었다. 이후 경추부 반자동 모드를 2주간 처치하여 통증척도가 완화되었으며, 두 달 동안 통증이 없는 상태로 유지되었음을 확인하였다. 본 사례는 무전조성 편두통을 관리하기 위해 척주 온열 마사지기 적용을 고려할 수 있음을 강조한다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권4호
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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.

• 정신신체의학
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• 제24권1호
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• pp.20-27
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• 2016

두통은 대부분의 사람들이 평생 한번씩은 경험하는 가장 흔한 신체증상이다. 심각한 상황을 야기하는 뇌종양과 같은 일부의 원인을 제외하고, 두통의 대부분은 편두통이나 긴장성 두통과 같은 일차성 두통으로 알려져 있다. 두통의 정확한 진단은 임상의들의 자세한 병력 청취와 신체 검사로부터 시작된다. 본 종설에서는 두통의 세부진단과 진단과정에 대해 고찰하고, 효과적인 약물치료 전략에 대해서 논의하고자 한다.