• 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.

• 대한상한금궤의학회지
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• v.11 no.1
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• pp.125-138
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• 2019

Objective : This study was intended to evaluate if treatment with Osuyu-Tang following the disease pattern identification diagnostic system based on Shanghanlun provisions (DPIDS) worked analyzing the progress of patients with migraine and restless legs syndrome and to reinterpret the provision of 309 Soyinbing Osuyu-Tang based on the analysis of whether it worked. Methods : Two cases treated with Soyinbing Osuyu-Tang were analyzed using DPIDS. The migraine and restless legs syndrome in both cases were evaluated using the migraine disability assessment (MIDAS) and the Korean versions of the international restless legs scale (K-IRLS), respectively. Results : In the first case, during 45 days of treatment, the MIDAS decreased from 10 days to 3 days. In the second case, during 30 days of treatment, the K-IRLS decreased from 30 to 9. In both cases, Soyinbing was associated with the disease, although the activity was less; and Leng (冷) was associated with numbness in the kneeling position. Conclusions : It was confirmed that treatment with Osuyu-Tang was effective against migraine and restless legs syndrome and that Leng could be associated with numbness in the kneeling position. The etymological analysis of the Shanghanlun characters suggested the possibility of further clarifying the clinical significance and interpretation of Shanghanlun.

• Korean Journal of Clinical Pharmacy
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• v.32 no.3
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• pp.178-184
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• 2022

Background: Migraine is one of the leading causes of poor quality of life and disability, and migraine incidences in pediatrics are increasing. Proper medication is important for the preventive and acute treatment of migraine. This study aimed to identify the current status of prescribed medication in pediatric patients with migraine. Methods: We used data from a sample of pediatric patients from the Health Insurance Review and Assessment Service (HIRA-PPS-2018) and analyzed the status of prescription drugs and frequency of visits to medical institutions with migraine diagnoses in pediatric patients. Results: A total of 12,228 pediatric patients diagnosed with migraine during 2018 were analyzed. Among these patients, 7,170 (58.64%) were girls and 9,510 (77.77%) were adolescents. Additionally, 9,157 patients (74.89%) received acute treatment, and 592 patients (4.84%) received combination therapy with analgesics and triptans. Acetaminophen for acute treatment and flunarizine for preventive treatment were the most commonly prescribed. In most children and adolescents, acute treatment drugs were prescribed for less than 14 days. Conclusion: Analgesics, such as acetaminophen or non-steroidal anti-inflammatory drugs, were prescribed frequently for acute treatment in pediatric patients with migraine. The drug prescription duration was within the recommended range, indicating a low risk of overdose. For preventive treatment, clinically studied medication for pediatric patients with migraine was used.

• The Journal of Korean Medicine
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• v.44 no.3
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• pp.140-149
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• 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.

• The Journal of Internal Korean Medicine
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• v.40 no.4
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• pp.637-648
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• 2019

Objective: The aim of this study was to investigate the effect of acupuncture on migraine prophylaxis. Method: Articles were searched from the online databases: PubMed, OASIS, NDSL, and RISS. The search keywords were "migraine prophylaxis" and "acupuncture." The inclusion criterion was randomized clinical trial. The exclusion criteria were in vivo, vitro, and review articles. Results: Eighty-nine articles were found among those published until March 2019. After reviewing the title, abstract, and original article, 10 articles were selected to show the effect of acupuncture for migraine prophylaxis. Conclusion: The effect of acupuncture for the frequency and number of days of a migraine and for the intensity of the pain seems to be effective, but the mechanism does not appear to be clear. Therefore, further research is needed in future acupuncture for migraine prevention.

• The Korean Journal of Pain
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• v.35 no.1
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• pp.4-13
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• 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.

• CELLMED
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• v.2 no.2
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• pp.17.1-17.5
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• 2012

Ayurveda is a nearly 3000 years old traditional medical system of India. Most of the time, people turn to ayurvedic physicians in desperate conditions. Here clinical practices of Ayurveda were initially found effective in the management of migraine among few patients. Later, it was developed as an ayurvedic treatment protocol (ATP) which consists of four herbo-mineral formulations (HMF), three meals and three snacks in a day with eight hours sleep at night. ATP brought significant relief in reducing the frequency, intensity of pain and associated symptoms in the migraine patients. IHS diagnostic criteria was followed to establish the diagnosis of migraine and uniform ATP was prescribed to each patient who were primarily treated by the ayurvedic physicians at their respective clinics. Such observations were presented at appropriate international forums. In an effort to validate the above, the present study carries the details of nine migraine patients who were first diagnosed and treated for migraine by a leading headache expert at Mumbai in India and were then referred to receive ATP. A total number of nine subjects volunteered to this program. Out of those, seven subjects completed 120 days of ATP. Five subjects reported significant improvement in overall symptoms of migraine. All subjects were followed up periodically for four years. No Grade II side effects were observed in any treated case. HMF has also been proved to be safe in experimental studies. Further pharmacological and randomized controlled clinical studies are in progress at the respective departments of a premier medical institute in India.

• Journal of Oriental Neuropsychiatry
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• v.22 no.4
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• pp.135-142
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• 2011

Objectives : The purpose of this case was to investigate the effectiveness of electroacupuncture for ophthamoplegic migraine. Methods : We provided electroacupuncture therapy and prescribed oriental medicine, Joganiknoe-tang daily. We measured patient's pain by VAS(Visual Analogue Scale) and eye movement with a ruler every five days. Results & Conclusions : Any patient who has a headache with paresis of the extraocular muscle should be considered for ophthalmoplegic migraine. To diagnose ophthalmoplegic migraine, family history, past medical history, associated symptoms and signs, neurologic examinations and neuroimaging tests are needed. The symptoms of patient improved gradually within 26days from the first day of admission, and we can see her complete recovery.

• Journal of Acupuncture Research
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• v.41 no.2
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• pp.115-120
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• 2024

Background: Migraine is a common disabling headache that affects every aspect of a person's life. Auricular acupuncture is a cost-effective treatment modality for the management of painful neurological conditions. Previous studies have shown the beneficial effects of a combination of ear points in the management of migraines. However, no studies have evaluated the efficacy of a single auricular point (i.e., sympathetic point) in migraine. Thus, this study evaluated the efficacy of sympathetic points on pain intensity and depression levels in patients with migraine. Methods: In this randomized controlled study, 100 patients with migraine aged 18-45 years were randomly divided into either an auricular acupuncture group (AAG) (n = 50) or a placebo control group (PCG) (n = 50). The AAG underwent needling at the sympathetic point (an auricular acupuncture point), whereas the PCG underwent needling at a non-acupuncture point for 20 minutes daily for 7 days. Assessments were performed before and after the intervention using a 6-item headache impact test (HIT-6) and Beck depression inventory (BDI) scale. Statistical analyses were performed using SPSS version 16. Results: In within-group analysis, the AAG showed a significant reduction in HIT-6 and BDI, whereas the PCG showed a significant increase in HIT-6 and a significant reduction in BDI. In between-groups analyses, HIT-6 reduced significantly in the AAG compared with that in the PCG, whereas BDI reduced significantly in the PCG compared with that in the AAG. Conclusion: In patients with migraine, needling at the sympathetic point produces a greater reduction in the pain intensity level and lesser reduction in the depression level compared to needling at a non-acupuncture point.

• Korean Journal of Acupuncture
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• v.40 no.3
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• pp.62-78
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• 2023

Objectives : This study aims to assess the impact of acupotomy on migraine through an examination of clinical studies conducted since 2015. Methods : We conducted a comprehensive search for randomized controlled trials (RCTs) and non-randomized controlled trials (nRCTs) related to acupotomy treatment for migraine, utilizing five Korean online databases (OASIS, Science ON, DBPIA, KISS, RISS), as well as four foreign online databases (CNKI, PubMed, EMBASE, Cochrane Library). We identified a total of 10 relevant studies for analysis. Participants characteristics, treatment points, combination treatments, treatment cycles or frequencies, evaluation indices, efficacy, and adverse events were analyzed. The risk of bias in the 10 RCTs was assessed using the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2.0). Results : A total of 931 participants were included in 10 studies. In the intervention group, the average duration of migraine morbidity ranged from 15.5±4.5 months to 15.9±4.2 years. Six studies based their diagnoses on the International Classification of Headache Disorders (ICHD), while five studies relied on Chinese diagnostic criteria. All studies specified the treatment area as the region exhibiting tenderness or induration on the head and neck. Treatment cycles ranged from a minimum of 2 days to a maximum of 1 week, with the number of days per treatment course varied from 5 days to 4 weeks. The diameter of acupuncture needles used varied between 0.3 mm and 1 mm. Of the eight studies specifying needle length, the shortest was 20 mm, and the longest was 40 mm. A total of eight evaluation indices were employed, with total efficacy rate (TER) and visual analogue scale (VAS) being the most frequently used. Statistically, all intervention groups showed more significant results compared to the control groups. Adverse events were reported in only two studies within the intervention group. Overall, the risk of bias assessment for the selected RCTs ranged from 'some concerns' to 'high risk of bias.' Conclusions : This study showed that acupotomy treatments for migraine were effective.