• 제목/요약/키워드: chronic headache

검색결과 214건 처리시간 0.028초

Management of Otogenic Brain Abscess Using the Transmastoid Approach

  • Choi, June;Choi, Jong Il;Kim, Sang-Dae
    • Journal of Korean Neurosurgical Society
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    • 제55권3호
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    • pp.178-180
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    • 2014
  • Despite significant advances in the treatment of all forms of chronic otitis media (COM), complications still can and do occur, with intracranial complications representing the most life-threatening cases, often requiring immediate therapeutic intervention. Herein, we present a rare case of rapidly progressing facial paralysis with concomitant severe headache and ipsilateral hearing loss secondary to an otogenic brain abscess, treated with the transmastoid approach, drainage, and facial nerve decompression.

Evaluation of Sleep Quality and Psychological Profiles in Patients with Chronic Painful Temporomadibular Disorders

  • Jeon, Hye-Mi;Han, Kyung-Hun;Ju, Hye-Min;Ahn, Yong-Woo;Ok, Soo-Min;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • 제45권2호
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    • pp.23-28
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    • 2020
  • Purpose: Temporomadibular disorders (TMDs) can result in chronic pain, which is often associated with psychological and sleep disturbance. Increased levels of psychological and sleep impairments are often related with poor treatment outcomes. The purpose of the present study was to evaluate clinical features, psychological profiles and the prevalence of clinical insomnia in TMD patients with chronic pain and to suggest an effective treatment approach. Methods: A total of 200 TMD patients who had visited the Pusan National University Hospital dental clinic for treatment of their pain were recruited from June 2018 through December 2019. TMD patients were classified into an acute (n=100) and chronic (n=100) group and compared the clinical symptoms. The primary diagnosis of TMD were categorized as TMD with joint pain group (TMD_J), TMD with muscle pain group (TMD_M) and TMD with joint-muscle mixed pain group (TMD_JM). Self- report measures of sleep quality and psychological profiles were evaluated via the Insomnia Severity Index (ISI) and the Korean Stress Response Inventory (SRI). Independent t-tests, Mann-Whitney U-tests, and chisquared test were used for the statistical analysis. Results: Chronic TMD patients showed higher pain intensity, as well as higher prevalence of related symptoms (headache, musculoskeletal pain) and myogenous pain. They also had significantly higher scores in all SRI parameters and a higher percentage of clinical insomnia than acute TMD patients. Conclusions: Based on the above results, psychological profiles and sleep quality assessments are necessary to provide essential data that will allow for improved treatment of chronic TMD patients.

육아종성 염증을 동반한 송과체 배아종 - 증례보고 - (Pineal Germinoma Associated with Chronic Granulomatous Inflammation - Case Report -)

  • 문경섭;정신;강삼석;김인영;김현우;이정길;김태선;김재휴;김수한;이제혁
    • Journal of Korean Neurosurgical Society
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    • 제30권sup1호
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    • pp.170-173
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    • 2001
  • Germinoma associated with chronic granulomatous inflammation of pineal gland has been rarely reported in the literature. The mechanism of chronic granulomatous inflammation is not understood well. We report a case of chronic granulomatous inflammation in pineal germinoma. In a 17 year-old male who suffered from headache and diplopia for six months, the mass of pineal gland was detected by brain MRI and removed through occipital transtentorial approach. The pathological specimen revealed the mass was predominantly composed of chronic granulomatous inflammation associated with small portion of germ cell tumor nests In the pathological interpretation of chronic granulomatous inflammation of pineal mass, it would be obliged to search for the presence of germ cell component.

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Posterior reversible encephalopathy syndrome caused by presumed Takayasu arteritis

  • Lee, Ki Wuk;Lee, Sang Taek;Cho, Heeyeon
    • Clinical and Experimental Pediatrics
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    • 제59권sup1호
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    • pp.145-148
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    • 2016
  • Takayasu arteritis (TA) is a chronic inflammatory disease of unknown etiology that affects mainly the aorta, main aortic branches, and pulmonary arteries. Diverse neurological manifestations of TA have rarely been reported in children. Posterior reversible encephalopathy syndrome (PRES) is a neuroradiological condition that presents with headache, seizure, visual disturbances, and characteristic lesions on imaging. Inflammatory condition and severe hypertension in TA can cause PRES. We report of a 5-year-old girl with presumed TA who presented with PRES and chronic total occlusion in the renal artery. The findings on magnetic resonance imaging suggested PRES. Left nephrectomy was performed for total occlusion of the left renal artery, and the confirmatory diagnosis of TA was based on the pathologic findings of the renal artery.

Non-Odontogenic Toothache Caused by the Fungal Ball of Maxillary Sinus: Case Reports

  • Ha, Ji-Woo;Jung, Won;Lee, Kyung-Eun;Suh, Bong-Jik
    • Journal of Oral Medicine and Pain
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    • 제44권4호
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    • pp.174-178
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    • 2019
  • A fungal ball (FB) of the paranasal sinuses is a chronic, non-invasive fungal sinusitis defined as the accumulation of dense aggregation of fungal hyphae in a sinus cavity. A patient with FB infection in a sinus cavity has usually non-specific symptoms such as post-nasal drip, nasal congestion, headache. However, facial pain and toothache can be developed if FB infection is in maxillary sinus. The aim of this case report is to present two cases of FB of the maxillary sinus which caused toothache in the upper molar region. It is also to make dental practitioners consider the non-odontogenic origins of toothache and to pay special attention to avoid unnecessary dental treatment.

Efficacy of ketamine in the treatment of migraines and other unspecified primary headache disorders compared to placebo and other interventions: a systematic review

  • Chah, Neysan;Jones, Mike;Milord, Steve;Al-Eryani, Kamal;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권5호
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    • pp.413-429
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    • 2021
  • Background: Migraine headaches are the second leading cause of disability worldwide and are responsible for significant morbidity, reduction in the quality of life, and loss of productivity on a global scale. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of ketamine on migraines and other primary headache disorders compared to placebo and other active interventions, such as midazolam, metoclopramide/diphenhydramine, and prochlorperazine/diphenhydramine. Methods: An electronic search of databases published up to February 2021, including Medline via PubMed, EMBASE, Web of Science, and Cochrane Library, a hand search of the bibliographies of the included studies, as well as literature and systematic reviews found through the search was conducted to identify randomized controlled trials (RCTs) investigating ketamine in the treatment of migraine/headache disorders compared to the placebo. The authors assessed the risk of bias according to the Cochrane Handbook guidelines. Results: The initial search strategy yielded 398 unduplicated references, which were independently assessed by three review authors. After evaluation, this number was reduced to five RCTs (two unclear risk of bias and three high risk of bias). The total number of patients in all the studies was 193. Due to the high risk of bias, small sample size, heterogeneity of the outcomes reported, and heterogeneity of the comparison groups, the quality of the evidence was very low. One RCT reported that intranasal ketamine was superior to intranasal midazolam in improving the aura attack severity, but not duration, while another reported that intranasal ketamine was not superior to metoclopramide and diphenhydramine in reducing the headache severity. In one trial, subcutaneous ketamine was superior to saline in migraine severity reduction; however, intravenous (I.V.) ketamine was inferior to I.V. prochlorperazine and diphenhydramine in another study. Conclusion: Further double-blind controlled studies are needed to assess the efficacy of ketamine in treating acute and chronic refractory migraines and other primary headaches using intranasal and subcutaneous routes. These studies should include a long-term follow-up and different ketamine dosages in diagnosed patients following international standards for diagnosing headache/migraine.

침을 이용한 전기자극 통증치료 (Electric Stimulation for Pain Relief Using Acupuncture Needles)

  • 신근만;홍순용;최영룡
    • The Korean Journal of Pain
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    • 제5권1호
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    • pp.52-56
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    • 1992
  • For pain relief my collegue and I used thin acupuncture needles as electrodes in electric stimulation. The needles were inserted into a trigger point and into another point located in the same muscle instead of meridian points of electro-acupuncture. Low frequency electric stimulation was given through the needles to 130 patients for 15 min. The results were as follows In 25 acute sprain patients electric stimulation was given $3.14{\pm}1.12$ times and the pain was reduced on the average by $83.00{\pm}6.77%$ (VAS). In 45 chronic sprain patients electric stimulation was given $5.51{\pm}1.38$ times and the pain was reduced on the average by $70.22{\pm}8.98%$ (VAS). In 28 myofascial pain syndrome patients electric stimulation was given $6.22{\pm}1.25$ times and the pain was reduced on the average by $66.48{\pm}8.75$(%). In 7 muscle contraction headache patients electric stimulation was given $4.14{\pm}1.57$ times and the pain was reduced on the average by $75.00{\pm}9.57%$ (VAS). In 25 radiculopathy patients electric stimulation was given $4.73{\pm}1.131$ times and the pain was reduced on the average by $21.37{\pm}9.31%$ (VAS). We he conclude that electric stimulation therapy using acupuncture needles is very effective in acute sprain, chronic sprain, myofascial pain syndrome and muscle contraction headache. Any doctor with knows anatomy and trigger points can practice this method without studying oriental medicine or difficult acupuncture techniques.

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인후두역류질환 (Laryngopharyngeal Reflux Disease, LPRD)에서 Rabeprazole Sodium($Pariet^{\circledR}$)의 임상효과 (The clinical effects of rabeprazole sodium($Pariet^{\circledR}$) in the treatment of Layngopharyngeal Reflux)

  • 최홍식;최현승;김한수
    • 대한기관식도과학회지
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    • 제9권1호
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    • pp.60-66
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    • 2003
  • Although there is a wide range of diseases caused by gastric acid reflux and the number of cases is on the rise, it is difficult for the laryngologist to make the correct diagnosis. The treatment for laryngopharyngeal reflux can be grouped into 3 categories - changes in lifestyle, medication, and surgery. The medication used to treat laryngopharyngeal reflux are prokinetic agents and acid supressive agents such as antacids, H2 blockers, and PPIs(Proton pump inhibitor). Rabeprazole sodium($Pariet^{\circledR}$) is a newly developed agent belonging to the PPI group, but in contrast with the existing drugs such as omeprazole, lansoprazole, pantoprazole, has a low dependency on CYP2C19 during the metabolic cycle. Thus, it is known to have a quick but fixed antiacid effect and less individual differences. We analyzed 2166 patients from 32 hospitals who were prescribed $Pariet^{\circledR}$ from May, 2001 to April, 2002. The patients were divided into 4 groups according to the duration of treatment - Group 1: 1-14 days, Group 2: 15-28 days, group 3: 29-56 days, Group 4: more than 56 days. The cases were then analyzed for improvement of 8 symptoms(heart bum, regurgitation, chronic cough, hoarseness, globus sensation, chronic throat clearing, sore throat, and dysphagia), improvement on laryngoscope, usefulness to the doctor, and complication development. Of the total of 2116 patients, 1627(75.1%) cases showed at least 50% improvement of symptoms and the amount of improvement increased according to the duration of medical treatment. Most of the patients showed objective improvement on the laryngoscope, with 32.9% showing significant improvement and 38.7% showing moderate improvement. 37.6% of the doctors questioned replied that $Pariet^{\circledR}$ was very useful and 50.3% said it was useful, showing that most were satisfied with the treatment results. The complications known to develop after taking PPI are headache, nausea, diarrhea, abdominal pain, constipation, dizziness, fatigue, and of these, only a small percentage of the patients complained of mild headache. $Pariet^{\circledR}$ has shown to be a relatively safe and effective drug for the treatment of laryngopharyngeal reflux.

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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;배정희;김성택
    • 구강회복응용과학지
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    • 제33권1호
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    • pp.1-6
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    • 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.

Survey of Fatigue-Related Health Conditions of General Population in a Metropolis

  • Son, Chang-Gue
    • 대한한의학회지
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    • 제32권6호
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    • pp.67-73
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    • 2011
  • Objectives: To examine the overview of fatigue-related health conditions in the Korean general population. Methods: Data were collected from 2,203 adults (1,126 men and 1,077 women) via a self-reporting questionnaire and their sleeping, exercise, stress, physical problems, use of functional food, and fatigue status were analyzed. Results: The average sleeping hours was about $6.6{\pm}2.0$ hrs per day, and 24.3% of subjects didn't exercise (over 30 min) in a week. Around 16.5% of subjects were under severe stress, and 46.1% (36.9% male vs. 55.6% female) had had trouble with at least one form of physical distress including dyspepsia, headache or muscular pain. 45.4% (37.2% male vs. 53.9% female) of subjects used functional supplements. 46.3% (42.8% male vs. 50.0% female) of subjects complained of chronic fatigue, and they were significantly different compared with no-fatigue subjects regarding severe stress status (8.6% vs. 24.0%), frequency of physical distress (33.2% vs. 69.9%), and use of functional supplements (41.6% vs. 49.8%). Conclusion: This result first reports the features of fatigue-related health conditions including prevalence of chronic fatigue in the Korean population. This data could be helpful to develop fatigue-focused traditional Korean medicine in the future.