• The Korean Journal of Pain
• /
• v.18 no.1
• /
• 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.

• Journal of Acupuncture Research
• /
• v.24 no.1
• /
• pp.13-28
• /
• 2007

Objectives : Clinical character of chronic tension-type headache is bilateral, moderate intensity, persistent and chronic, repeating disease and CTTH is a common prevalent disease, but pathophysiology and likely mechanism remain unclear. It impedes subjective quality of life. The purpose of this research is to examine the effect of sa-am acupuncture method for chronic tension-type headache. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with sham acupuncture for the treatment of chronic tension-type headache. Volunteers who satisfied the requirements were enrolled in study. Evaluation of chronic tension-type headache was measured by VAS and Headache Disability Inventory(HDI), Six point Linkert Scale before and after treatments. Results : 26 subjects finished study. There were not difference between two groups on age, sex, weight, height, blood pressure, pulse, respiratory rate, Byeonjeung, sunrise of treatment. In change of VAS, there were not difference between two groups on before treatment. Before treatment per visit, VAS of 6th and 7th visit were significantly decreased in active acupuncture(each p=0.039, p=0.008) and were not decreased in sham acupuncture. In change of VAS on a withdrawing needling after treatment, VAS of 1st, 2nd, 6th and 7th visit were significantly decreased in active acupuncture (each p=0.001, 0.038, 0.035, 0.008) and VAS of 2nd, 4th and 5th, 6th visit were significantly decreased in sham acupuncture(each p=0.033, 0.032, 0.035, 0.031). In change of VAS on 2hrs after treatment, VAS of 4th and 5th, 6th visit were significantly decreased in active acupuncture(each p=0.014, 0.023, 0.027) and 5th visit were significantly decreased in sham acupuncture(each p=0.004, 0.009). In change of VAS on 4hrs after treatment, VAS of 4th and 5th, 6th visit were significantly decreased in active acupuncture(each p=0.018, 0.011, 0.015) and 5th, 6th visit were significantly decreased in sham acupuncture(each p=0.020, 0.015). In change of VAS on the next day after treatment, VAS of 3th and 4th and 5th, 6th visit were significantly decreased in active acupuncture(each p=0.032, 0.011, 0.005, 0.012) and 4th, 5th visit were significantly decreased in sham acupuncture(each p=0.001, 0.012). In change of VAS according to a current time(before treatment, after a withdrawing needling, 2hrs, 4hrs, the next day), total score of VAS was decreased more active acupuncture group than sham acupuncture group, but there were no statistical significance compared with sham acupuncture group. In change of HDI score, after treatment was decreased than before treatment in two group, but there were no statistical significance compared with two group. In change of Six point Linkert scale score, after treatment was decreased than before treatment in two group on 6th, 7th visit(active acupuncture 6th 7th each p=0.002, 0.003, sham acupuncture 6th 7th each 0.003, 0.009), but there were no statistical significance compared with tow group. Conclusion : Sa-am acupuncture treatment is effective to improve the symptoms and quality of life in patients with chronic tension-type headache.

• Clinical and Experimental Pediatrics
• /
• v.58 no.2
• /
• pp.73-76
• /
• 2015

Isolated sphenoid sinusitis is a rare disease in children, and its symptoms are often nonspecific and confusing. Rarely, severe headache can be the first or only symptom of isolated sphenoid sinusitis. New daily persistent headache (NDPH) is a form of chronic daily headache that may have features of both migraines and tension-type headaches. NDPH is difficult to diagnose and requires a multifaceted approach. Here, we report on a 10-year-old boy and an 11-year-old girl who both presented with typical NDPH symptoms. These patients had no nasal symptoms or signs of infection. Neither nonsteroidal anti-inflammatory drugs nor topiramate had any effect on the headaches. Their neurological and ophthalmological examinations were normal. The results of routine blood work, including thyroid function tests, inflammatory markers, complete blood count, tests for viral infection, and a metabolic panel, were normal. A brain magnetic resonance imaging scan showed isolated sphenoid sinusitis. Both patients' symptoms resolved completely after approximately 1 month of oral antibiotics for sinusitis.

• Journal of Sasang Constitutional Medicine
• /
• v.25 no.4
• /
• pp.384-395
• /
• 2013

Objectives We report a series of 3 chronic tension-type headache cases who were constitutionally typed as the Soeum type, Taeeum type and treated with Dangguibaekhaoguanjung-tang, Chungshimyeonja-tang or Chunghyulganggui-tang. Methods In treating 1 patient who was constitutionally typed as the Soeum type, Case 1 fell into the category of the Taeeum symptomatology, 2 patients who were constitutionally typed as the Taeeum type, Case 2 and Case 3 fell into the category of Dry-Heat symptomatology. Each patient was given Sasang medication according to protocol: Dangguibaekhaoguanjung-tang to Case 1, Chungshimyeonja-tang to Case 2, Chunghyulganggui-tang to Case 3. On admission day and approximately 2 weeks later, patients evaluated their pain and quality of life using SF-36 and HIT-6. The patients symptoms were observed daily and NRS scores were recorded daily. Results and Conclusions 2 Patients(Case1, Case2) showed improvement in their NRS scores, SF-36 scores and HIT-6 scores. 1 patient(Case3) showed improvement in NRS scores, but worse SF-36 scores and no improvement in HIT-6 scores. Treating chronic tension-type headache based on Sasang Constitutional therapy was found to be effective for managing pain. The treatment protocol suggested in this investigation should be explored and verified in future studies.

• Journal of Pharmacopuncture
• /
• v.13 no.4
• /
• pp.109-118
• /
• 2010

Objectives : This pilot study is designed to reveal the effect of Carthami-semen acupuncture treatment on chronic daily headache. Methods : 1. All the voluntary subjects were diagnosed as CDH. 2. Carthami-semen acupuncture is applied 2 times a week for 4 weeks. 3. The patients were assessed by Headache impairment test score(HIT), Short Form 36 (SF-36) Health Survey, and Headache Free Days(HFD) before and after 4 weeks treatment, and two weeks the treatment finished. Results : The result were as follows ; 1. HIT score decreased from $65.3{\pm}5.5$ to $53.1{\pm}9.4$, and furthermore declined to $49.5{\pm}8.0$ after 2 weeks the treatment finished. 2. HFD increased from 19.1% to 31.5% during the treatment time. Moreover it showed continuous effectiveness after 2 weeks the treatment finished. 3. SF-36 showed significant improvement on all of the QOL items. Conclusions : This pilot study suggests that Carthami-semen acupuncture treatment has an effect on the CDH patients.

• Korean Journal of Psychosomatic Medicine
• /
• v.7 no.2
• /
• pp.263-273
• /
• 1999

Headache is a symptom with varied etiologies and extraordinarily frequent. Headaches can be a symptom of another diseases, such as meningitis, subarachnoid hemorrhage or brain tumor, may represent the disease entity itself as the case in migraine. The international Headache Society criteria were the first to distinguish between primary and secondary headache disorders. When evaluating a patient who presents with headache, the physician abviously needs to identify or exclude the myriad conditions that can cause secondary headache and initial diagnostic workup should be considered. If patient meets the criteria for a primary headache disorder, treatment commonly initiated without additional neurodiagnostic tests. The headache type, its associated feature, and the duration and the intensity of the pain attack all can influence the choice of acute therapy in migraine. Pharmacologically, such as NSAIDs, combination analgesics, vasoactive antimigraineous drugs, neuroleptics, antidepressants, or corticosteroids. Other approches to managing headache include a headache diary to identify triggers, biofeedback, relaxation technique and behavioral modification. Daily preventive medication should be considered by his attack frequency and intensity, and maintained for 4 to 6 months. Tension-type headaches are distinguished between episodic and chronic tension-type headache, but physician must make sure that patient is not drug-overuse or independent during symptomatic abortive therapy or preventive medication. The most difficult headache patients to treat are those with chronic daily headache. They often have physical dependency, low frustration tolerance, sleep problems, and depression. So discontinuation of overused medication is crucial. New developments in migraine therapy are broadening the scope of abortive and prophylactic treatment choices available to the physician. The enhanced ease of the use of sumatriptan and DHE will likely increase patient compliance and satisfaction.

• Herbal Formula Science
• /
• v.16 no.1
• /
• pp.55-64
• /
• 2008

The span of life of human beings has lengthened because of medical progress and so on. Consequently, the old have begun to remark that quality of life (QOL) is as important as extension of the life expectancy. However, some diseases such as stroke, cancer induce decrease of QOL. In case of the stroke, it is followed by chronic headache and dementia as an aftereffect, causing serious decrease of QOL. Jodeungsan, traditional medicine, have been prescribed for headache and hypertension. Many clinical trials and laboratory experiments about pharmacological effects of Jodeungsan have been reported. Jodeungsan ameliorated chronic headache and improved recognitive deficit. Moreover, Jodeungsan lowered blood pressure in hypertensive condition which is one of a major cause of stroke. These effects of Jodeungsan on several diseases are partly attributed to antioxidant effect. This report reviews the pharmacological effect of Jodeungsan in the view of stroke-related diseases.

• The Journal of Korean Physical Therapy
• /
• v.21 no.4
• /
• pp.9-16
• /
• 2009

Purpose: This study was done to assess the effect of changes in forward head posture (FHP), neck mobility and headache clinical parameters on episodic tension-type headache (ETTH) and chronic tension-type headache (CTTH) who did craniocervial exercises. Methods: Twelve CTTH subjects and twelve ETTH subjects were studied. Side-view pictures of subjects were taken in both sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. Cervical range of motion (CROM) was employed to measure cervical mobility. A headache diary was kept to assess headache intensity, frequency, and duration. All subjects did three types of craniocervical exercise over 8 weeks. Measurements were done at pre-treatment, and at 4 and 8 weeks post-treatment. Results: Forward head posture and headache-related clinical parameters showed a significant improvement after craniocervical exercise (p<0.05). Flexion/extension and left/right rotation of CROM was significantly increased after the intervention (p<0.05), whereas changes in left/right bending did not reach statistical significance. Conclusion: This study indicates that craniocervical exercise may be effective in the management of tension-type headache.

• Journal of Oral Medicine and Pain
• /
• v.18 no.2
• /
• pp.55-69
• /
• 1993

The purpose of this study is investigation on prevalence and clinical characteristics of headache among 10-39 years men and women. Information could be obtained with the questionnaire, and 1952 respondents completed the questionnaire. All participants were asked if they had experienced headache. Those responding positively were further questioned regarding the frequency, severity, character, location and duration of headache and were questioned regarding the experience of medical cunsultation and taking analgesics. The obtained results were as follows : 1. The life time prevalence of headache was 49.6% among men, 70.8% among women and 61.5% in all. 2. The prevalence of episodic tension type headache, chronic tension type headache, migraine, mixed type headache in this population was 27.1%, 5.0%, 2.8%, 23.1% respectively. 3. Headache duration was classified as less than 1 hour, 1-6 hours, 6012 hours, more than 12 hours for 1 day. The percentage of each other case is 41.8%, 46.2%, 7.4% and 4.4% of headache suffers respectively. 4. As regards the severity of headache, 4.2% of headache suffers had a very mild pain intensity, 17.9% a mild pain, 57.7% a moderate pain, 18.1% a severe pain and 2.2% a quite severe pain. 5. Headache occured at morning in 8.2% of headache suffers, at afternoon in 9.4%, at evening in 18.1%, at night in 4.3% and at anytime in 59.9%. 6. 11.7% of headache suffers among men consulted doctor, 13.9% among women and 13.1% in all. 7. 66.2% of headache suffers didnt have any analgesics because of their pain, 33.8% of headache suffers had analgesics because of their pain.

• Journal of Oriental Neuropsychiatry
• /
• v.15 no.2
• /
• pp.221-228
• /
• 2004

Many literature-based researches have been thus far reported of Hwa-Byung in oriental medicine and Hwa-Byung is considered as culture-bound syndrome of Korea. It is showed practically middle-aged women and connected with emotion of Han(恨)and its progress generally chronic. But this case described a 36-year old man who diagnosed as Hwa-Byung by HBDIS. He complained chiefly headache and suffered from chest discomfort and sleep disorder. After acupuncture teatment, herbal medication and oriental psychotherapy, his condition got improved. This report is for better understanding of this disease, that Hwa-byung can be seen in male according to changes of social environment.