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Most-read articles are from the articles published in 2023 during the last three month.

Review Articles
Update on Tension-type Headache
Hye Jeong Lee, Soo-Jin Cho, Jong-Geun Seo, Henrik Winther Schytz
Headache Pain Res. 2025;26(1):38-47.   Published online December 30, 2024
DOI: https://doi.org/10.62087/hpr.2024.0025
  • 3,364 View
  • 144 Download
AbstractAbstract PDF
Tension-type headache (TTH) is the most common type of headache, characterized by mild to moderate intensity, bilateral, with a pressing or tightening (non-pulsating) quality. Migraine and TTH can occur in the same person, and their risk factors and treatments can overlap. However, TTH receives less attention than migraine. Furthermore, despite the expanding market for migraine treatments targeting calcitonin gene-related peptide (CGRP) mechanisms, the lack of evidence regarding mechanisms related to CGRP-related mechanisms in TTH continues to be neglected. There remains a need to develop effective preventive treatments for chronic TTH, which imposes a very high burden of disease. From this perspective, this review aims to provide the latest evidence on TTH.
Menstrual Migraine: A Review of Current Research and Clinical Challenges
Jong-Geun Seo
Headache Pain Res. 2024;25(1):16-23.   Published online April 22, 2024
DOI: https://doi.org/10.62087/hpr.2024.0004
  • 6,180 View
  • 178 Download
  • 6 Citations
AbstractAbstract PDF
The term “menstrual migraine” is commonly used to describe migraines that occur in association with menstruation, as distinct from other migraine types. A significant proportion of women of reproductive age experience migraine attacks related to their menstrual cycle. Menstrual migraine is characterized by migraine attacks occurring on day 1±2 (i.e., days −2 to +3) of menstruation in at least two out of three menstrual cycles. Although the reported prevalence of menstrual migraine varies considerably, population-based studies have found that menstrual migraine affects up to 60% of women with migraines. Several hypotheses have been proposed to explain the etiology of menstrual migraine, among which the estrogen withdrawal hypothesis is the most widely accepted. Women who experience menstrual migraines often face considerable disability due to perimenstrual attacks. Studies have reported that perimenstrual attacks are more severe and more difficult to manage. The principles of acute managing perimenstrual attacks are the same as those for managing nonmenstrual attacks. Short-term preventive therapy is needed to prevent menstrual migraines before they occur during the perimenstrual period. This review summarizes the prevalence, distinct clinical features, pathophysiological mechanisms, and management of menstrual migraine.

Citations

Citations to this article as recorded by  
  • Sex hormones and diseases of the nervous system
    Hyman M. Schipper
    Brain Medicine.2025; : 1.     CrossRef
  • Evidence-Based Recommendations on Pharmacologic Treatment for Migraine Prevention: A Clinical Practice Guideline from the Korean Headache Society
    Byung-Su Kim, Pil-Wook Chung, Jae Myun Chung, Kwang-Yeol Park, Heui-Soo Moon, Hong-Kyun Park, Dae-Woong Bae, Jong-Geun Seo, Jong-Hee Sohn, Tae-Jin Song, Seung-Han Lee, Kyungmi Oh, Mi Ji Lee, Myoung-Jin Cha, Yun-Ju Choi, Miyoung Choi
    Headache and Pain Research.2025; 26(1): 5.     CrossRef
  • Morning Headaches: An In-depth Review of Causes, Associated Disorders, and Management Strategies
    Yooha Hong, Mi-Kyoung Kang, Min Seung Kim, Heejung Mo, Rebecca C. Cox, Hee-Jin Im
    Headache and Pain Research.2025; 26(1): 66.     CrossRef
  • Migraine in Women: Inescapable Femaleness?
    Soo-Kyoung Kim
    Headache and Pain Research.2024; 25(1): 1.     CrossRef
  • Three-month treatment outcome of medication-overuse headache according to classes of overused medications, use of acute medications, and preventive treatments
    Sun-Young Oh, Jin-Ju Kang, Hong-Kyun Park, Soo-Jin Cho, Yooha Hong, Mi-Kyoung Kang, Heui-Soo Moon, Mi Ji Lee, Tae-Jin Song, Young Ju Suh, Min Kyung Chu
    Scientific Reports.2024;[Epub]     CrossRef
  • Understanding the Connection between the Glymphatic System and Migraine: A Systematic Review
    Myoung-Jin Cha, Kyung Wook Kang, Jung-won Shin, Hosung Kim, Jiyoung Kim
    Headache and Pain Research.2024; 25(2): 86.     CrossRef
Migraines in Women: A Focus on Reproductive Events and Hormonal Milestones
Seonghoon Kim, Jeong Wook Park
Headache Pain Res. 2024;25(1):3-15.   Published online April 5, 2024
DOI: https://doi.org/10.62087/hpr.2024.0003
  • 5,544 View
  • 146 Download
  • 7 Citations
AbstractAbstract PDF
Migraine, a prevalent neurological disorder, is more common in women than in men. This sex difference is more pronounced after menarche and diminishes after menopause. Migraines in women are influenced by the menstrual cycle, pregnancy, and lactation, suggesting a connection to sex hormones, known as the estrogen withdrawal theory. Beyond endogenous hormonal changes accompanying reproductive events, exogenous hormonal factors such as contraceptives or hormone replacement therapy may also affect migraines. The hormonal influence cannot be explained simply by serum estrogen levels; instead, it involves a complex interplay of various factors. Here, we delineate aspects of migraines associated with endogenous and exogenous hormonal changes over the course of a woman’s life, exploring the mechanisms and contributing factors through which sex hormones influence migraines.

Citations

Citations to this article as recorded by  
  • Framing and Management of Migraines in Women: An Expert Opinion on Challenges, Current Approaches, and Future Multidisciplinary Perspectives
    Piero Barbanti, Rossella E. Nappi
    Healthcare.2025; 13(2): 164.     CrossRef
  • Morning Headaches: An In-depth Review of Causes, Associated Disorders, and Management Strategies
    Yooha Hong, Mi-Kyoung Kang, Min Seung Kim, Heejung Mo, Rebecca C. Cox, Hee-Jin Im
    Headache and Pain Research.2025; 26(1): 66.     CrossRef
  • Calcitonin Gene-Related Peptide Monoclonal Antibody Treatment in Nine Cases of Persistent Headache Following COVID-19-Infection
    Soyoun Choi, Yooha Hong, Mi-Kyoung Kang, Tae-Jin Song, Soo-Jin Cho
    Journal of Korean Medical Science.2025;[Epub]     CrossRef
  • Migraine in Women: Inescapable Femaleness?
    Soo-Kyoung Kim
    Headache and Pain Research.2024; 25(1): 1.     CrossRef
  • Three-month treatment outcome of medication-overuse headache according to classes of overused medications, use of acute medications, and preventive treatments
    Sun-Young Oh, Jin-Ju Kang, Hong-Kyun Park, Soo-Jin Cho, Yooha Hong, Mi-Kyoung Kang, Heui-Soo Moon, Mi Ji Lee, Tae-Jin Song, Young Ju Suh, Min Kyung Chu
    Scientific Reports.2024;[Epub]     CrossRef
  • Subjective Cognitive Decline Patterns in Patients with Migraine, with or without Depression, versus Non-depressed Older Adults
    Sun Hwa Lee, Soo-Jin Cho
    Headache and Pain Research.2024; 25(2): 103.     CrossRef
  • Understanding the Connection between the Glymphatic System and Migraine: A Systematic Review
    Myoung-Jin Cha, Kyung Wook Kang, Jung-won Shin, Hosung Kim, Jiyoung Kim
    Headache and Pain Research.2024; 25(2): 86.     CrossRef
Morning Headaches: An In-depth Review of Causes, Associated Disorders, and Management Strategies
Yooha Hong, Mi-Kyoung Kang, Min Seung Kim, Heejung Mo, Rebecca C. Cox, Hee-Jin Im
Headache Pain Res. 2025;26(1):66-79.   Published online January 17, 2025
DOI: https://doi.org/10.62087/hpr.2024.0023
  • 1,995 View
  • 39 Download
AbstractAbstract PDF
Morning headaches, which are defined by occurrence upon or shortly after waking up in the morning, range from mild discomfort to severe pain and significantly impact an individual’s quality of life. Although morning headaches are a prevalent and potentially debilitating condition, the criteria for defining these headaches vary. The lack of universally accepted diagnostic criteria complicates understanding their etiology, associated factors, and potential interventions. The causes of morning headaches are multifaceted, including primary headache disorders like migraines and cluster headaches, and secondary causes such as sleep disorders, hypertension, abnormal intracranial pressure, and brain parenchymal diseases. Psychological factors, including anxiety and depression, as well as substance use, further complicate the clinical presentation, often requiring a multidisciplinary approach for effective diagnosis and treatment. This review provides a comprehensive overview of morning headaches, examining their various aspects and possible treatment options, with the goal of enhancing clinicians’ understanding and management of this common yet often overlooked condition.
The Current Role of Artificial Intelligence in the Field of Headache Disorders, with a Focus on Migraine: A Systemic Review
Wonwoo Lee, Min Kyung Chu
Headache Pain Res. 2025;26(1):48-65.   Published online February 17, 2025
DOI: https://doi.org/10.62087/hpr.2024.0024
  • 2,112 View
  • 65 Download
AbstractAbstract PDF
The application of artificial intelligence (AI) in the field of headache disorders, particularly migraine, is rapidly expanding, and AI has demonstrated significant potential for diagnosis, treatment, and research. This review examines the current role of AI in migraine management, categorizing AI applications into diagnosis and classification, assessment of treatment response, prediction of migraine attacks, and research. A systematic search of literature published between 2000 and 2024 was conducted, following PRISMA guidelines and utilizing the snowball technique. Of the 398 articles identified, along with five additional articles, 61 were finally reviewed. The results highlight promising AI applications, including the use of patient questionnaires, natural language processing, and imaging for migraine diagnosis, as well as predicting treatment responses and forecasting migraine attacks. Nonetheless, challenges remain in improving the accuracy, generalizability, validation, and clinical relevance of AI applications. Despite the substantial promise of AI for improving migraine management, it does not always guarantee better results than traditional methods. Careful consideration of the study design and method selection is crucial. Additionally, the interpretation of AI-generated results, particularly those from generative models, requires caution to avoid potential pitfalls.
Update on Cluster Headaches: From Genetic to Novel Therapeutic Approaches
Myun Kim, Je Kook Yu, Yoo Hwan Kim
Headache Pain Res. 2024;25(1):42-53.   Published online April 22, 2024
DOI: https://doi.org/10.62087/hpr.2024.0009
  • 4,415 View
  • 73 Download
  • 6 Citations
AbstractAbstract PDF
Cluster headaches affect 0.1% of the population and are four times more common in males than in females. Patients with this condition present with severe unilateral head pain localized in the frontotemporal lobe, accompanied by ipsilateral lacrimation, conjunctival injection, nasal congestion, diaphoresis, miosis, and eyelid edema. Recently, the first genome-wide association study of cluster headaches was conducted with the goal of aggregating data for meta-analyses, identifying genetic risk variants, and gaining biological insights. Although little is known about the pathophysiology of cluster headaches, the trigeminovascular and trigeminal autonomic reflexes and hypothalamic pathways are involved. Among anti-calcitonin gene-related peptide monoclonal antibodies, galcanezumab has been reported to be effective in preventing episodic cluster headaches.

Citations

Citations to this article as recorded by  
  • Exercise as an abortive treatment for cluster headaches: Insights from a large patient registry
    Mi‐Kyoung Kang, Yooha Hong, Soo‐Jin Cho
    Annals of Clinical and Translational Neurology.2025; 12(1): 149.     CrossRef
  • Morning Headaches: An In-depth Review of Causes, Associated Disorders, and Management Strategies
    Yooha Hong, Mi-Kyoung Kang, Min Seung Kim, Heejung Mo, Rebecca C. Cox, Hee-Jin Im
    Headache and Pain Research.2025; 26(1): 66.     CrossRef
  • Does Laterality Matter? Insights Into Unilateral Pain in Cluster Headache
    Tae-Jin Song
    Journal of Clinical Neurology.2025; 21(3): 157.     CrossRef
  • Pain Lateralization in Cluster Headache and Associated Clinical Factors
    Soohyun Cho, Mi Ji Lee, Min Kyung Chu, Jeong Wook Park, Heui-Soo Moon, Pil-Wook Chung, Jong-Hee Sohn, Byung-Su Kim, Daeyoung Kim, Kyungmi Oh, Byung-Kun Kim, Soo-Jin Cho
    Journal of Clinical Neurology.2025; 21(3): 220.     CrossRef
  • Side Shift of Attacks in Cluster Headache: A Prospective Single-center Study
    Michelle Sojung Youn, Jun Pyo Kim, Mi Ji Lee
    Headache and Pain Research.2024; 25(2): 96.     CrossRef
  • Reduction of neck pain severity in patients with medication-overuse headache
    Yooha Hong, Hong-Kyun Park, Mi-Kyoung Kang, Sun-Young Oh, Jin-Ju Kang, Heui-Soo Moon, Tae-Jin Song, Mi Ji Lee, Min Kyung Chu, Soo-Jin Cho
    The Journal of Headache and Pain.2024;[Epub]     CrossRef
Efficacy and Safety of Repetitive Transcranial Magnetic Stimulation in Postherpetic Neuralgia: A Systematic Review and Meta-Analysis
Abdallah Abbas, Basant Lashin, Mohamed Abouzid, Hadir Mustafa Mohamed, Mohamed El-Moslemani, Mohamed A. Zanaty, Haneen Sabet, Dina Essam Abo-elnour, Ahmed Ibrahim Ghonimy Shedid, Mohamed Salah Mohamed Syed, Amna Hussein, Hoda Awad, Ahmed M. Raslan
Headache Pain Res. 2025;26(2):91-105.   Published online April 16, 2025
DOI: https://doi.org/10.62087/hpr.2024.0032
  • 1,618 View
  • 34 Download
AbstractAbstract PDFSupplementary Material
This study evaluated the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) for pain management in postherpetic neuralgia (PHN). A comprehensive literature search was conducted through May 2024 in Scopus, PubMed, Web of Science, and Cochrane Library. Eligible studies included clinical trials, observational, and case-control studies. Two reviewers independently screened studies and extracted data. Risk of bias was assessed using RoB 2 for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies. Meta-analysis was performed using Review Manager v.5.3, with heterogeneity evaluated by chi-square and I² tests. Five studies (245 patients) were included, with rTMS sessions ranging from 10 to 28. Meta-analysis showed significant pain reduction with rTMS compared to sham treatment. At 2 weeks post-treatment, the mean pain score difference (visual analogue scale) was –1.44 (95% CI: –2.12 to –0.77; p<0.0001), with sustained relief at 1 and 3 months. However, no significant differences were found in the patient’s global impression of change scale, sleep quality, quality of life (QoL), medication regulation, or adverse events. rTMS exerted a consistent pain relief effect of rTMS, but its impact on broader aspects of patient well-being was less clear. rTMS provides sustained pain relief in PHN for up to 3 months, but its impact on QoL and secondary outcomes remains unclear, warranting further investigation.
Vestibular Migraine: Challenges in Diagnosis and Management
Byung-Kun Kim
Headache Pain Res. 2025;26(2):106-115.   Published online June 11, 2025
DOI: https://doi.org/10.62087/hpr.2025.0001
  • 837 View
  • 27 Download
AbstractAbstract PDF
Vestibular migraine (VM) remains a clinical challenge due to its heterogeneous presentation and the frequent absence of typical migraine features during vestibular episodes. Although many studies have adopted the diagnostic criteria defined by the International Classification of Headache Disorders (ICHD), interpretation of findings is often complicated by variability in how these criteria are applied across studies. VM is frequently underdiagnosed or misdiagnosed, owing to its clinical overlap with other vestibular disorders. This review provides a comprehensive overview of the epidemiology, diagnostic criteria, differential diagnosis, and treatment strategies for VM. Particular emphasis is placed on distinguishing VM from other causes of vertigo to support accurate diagnosis and tailored management. By synthesizing current evidence, this review aims to improve clinical recognition, diagnostic precision, and therapeutic outcomes for patients with this under-recognized and often debilitating condition.
Advances in Primary Stabbing Headache: Diagnostic Criteria, Epidemiological Insights, and Tailored Treatment Approaches
Ayush Chandra, Avinash Chandra, Soohyun Cho
Headache Pain Res. 2025;26(1):80-87.   Published online September 2, 2024
DOI: https://doi.org/10.62087/hpr.2024.0018
  • 1,471 View
  • 30 Download
AbstractAbstract PDF
Primary stabbing headache (PSH), characterized by sudden, localized stabbing headache pain, is a recognized primary headache disorder with evolving diagnostic criteria. Epidemiological studies show a wide range of prevalence, influenced by various factors. PSH is more common in females, frequently occurring in conjunction with migraine, and can manifest in children. Recent diagnostic criteria have changed the definition of sharp stabbing pain, which is no longer restricted to the first division of the trigeminal nerve. In addition, the criterion of “no accompanying symptoms” has been refined to “no cranial autonomic symptoms” specifically. These changes have increased the sensitivity for capturing PSH. Although it is generally considered benign, stabbing headache can be associated with secondary causes. Clinical red flag signs can be helpful in distinguishing secondary headaches from PSH. A recent prospective study has proposed the monophasic, intermittent, and chronic patterns as subtypes, and this division may be helpful for predicting the prognosis. Pharmacological treatment is typically not required for PSH, although indomethacin and other alternating agents can be used. The treatment should be selected based on individual clinical features and comorbidities. This review aims to highlight the necessity of recognizing the distinctive clinical profile of PSH and of tailoring treatment approaches to patients’ individual needs.
What a Neurologist Should Know about Functional Anatomy for Botulinum Toxin Injections in the Head, Face, and Neck: A Practical Perspective
So Ra Kim, Vittorio Favero, Alec Hyung Kim, SeongTaek Kim
Headache Pain Res. 2024;25(2):77-85.   Published online July 22, 2024
DOI: https://doi.org/10.62087/hpr.2024.0005
  • 2,044 View
  • 88 Download
  • 1 Citations
AbstractAbstract PDF
Since botulinum toxin (BoNT) was approved by the US Food and Drug Administration as a prophylactic treatment for chronic migraines in 2010, subsequent studies have shown that BoNT is effective in the management of chronic migraines due to its pain-relieving effects. Therefore, neurologists are increasingly utilizing BoNT as a therapeutic tool for chronic migraine. It is crucial to thoroughly understand the functional anatomy in the head, face, and neck regions to successfully administer BoNT injections in these areas. This review describes the complexity of muscles and their associated target nerves in the frontal, temporal, and occipital areas and serves as a resource for essential functional anatomy, with the goal of providing clinicians with a practical perspective on utilizing BoNT injections.

Citations

Citations to this article as recorded by  
  • When Should Headache Specialists Hold a Needle? The Role of Botulinum Toxin Injections and Occipital Nerve Blocks
    Soo-Jin Cho
    Headache and Pain Research.2024; 25(2): 73.     CrossRef
Original Articles
Premonitory Symptoms in Migraine: Implications for Disease Burden and Cognitive Impairment, with Some Promising Answers
Utku Topbaş, Bahar Taşdelen, Nevra Öksüz Gürlen, Aynur Özge
Headache Pain Res. 2025;26(2):130-141.   Published online May 26, 2025
DOI: https://doi.org/10.62087/hpr.2024.0031
  • 615 View
  • 15 Download
AbstractAbstract PDF
Purpose: This study evaluated the prevalence and impact of premonitory symptoms (PS) in people with migraine, assessing their influence on disability, cognitive function, and quality of life.
Methods
In a cross-sectional analysis at Mersin University Hospital, 186 migraine patients were interviewed to identify the presence of PS, using a structured questionnaire that included measures of disability (Migraine Disability Assessment Scale or MIDAS), quality of life (European Health Impact Scale or EUROHIS-8), and cognition (Migraine Attack Related Subjective Cognitive Scale or Mig-SCOG). Statistical analyses included descriptive statistics, the t-test, and the Mann-Whitney U-test, with a significance threshold set at p<0.05.
Results
Among participants, 74.7% reported one or more PS, with the most common being neck stiffness (64.7%), photophobia (56.8%), fatigue (52.8%), and phonophobia (50.3%). Patients with PS demonstrated significantly lower quality of life scores (EUROHIS-8, p<0.001) and higher cognitive impairment scores (Mig-SCOG, p<0.001) than those without PS, despite similar levels of migraine disability (MIDAS, p=0.050).
Conclusion
The high prevalence of PS in people with migraine and their association with greater cognitive impairment and reduced quality of life indicate that more targeted interventions are necessary in this subgroup. PS may be either a driver of cognitive and quality of life burden or just a marker of it, and disambiguating these possibilities will be a critical area for future research and clinical focus. More optimized and standardized prospective studies are needed to clarify the prevalence of PS.
Evidence-Based Recommendations on Pharmacologic Treatment for Migraine Prevention: A Clinical Practice Guideline from the Korean Headache Society
Byung-Su Kim, Pil-Wook Chung, Jae Myun Chung, Kwang-Yeol Park, Heui-Soo Moon, Hong-Kyun Park, Dae-Woong Bae, Jong-Geun Seo, Jong-Hee Sohn, Tae-Jin Song, Seung-Han Lee, Kyungmi Oh, Mi Ji Lee, Myoung-Jin Cha, Yun-Ju Choi, Miyoung Choi
Headache Pain Res. 2025;26(1):5-20.   Published online January 16, 2025
DOI: https://doi.org/10.62087/hpr.2024.0019
  • 1,169 View
  • 78 Download
  • 3 Citations
AbstractAbstract PDF
Purpose: The aim of this clinical practice guideline (CPG) from the Korean Headache Society is to provide evidence-based recommendations on the pharmacologic treatment for migraine prevention in adult migraine patients.
Methods
The present CPG was developed based on the guideline adaptation methodology through a comprehensive systematic search for literature published between January 2012 and July 2020. The overall quality of the CPGs was assessed using the Korean version of the Appraisal of Guidelines for Research and Evaluation II tool. High-quality CPGs were adapted to make key recommendations in terms of strength (strong or weak) and direction (for or against).
Results
The authors selected nine available high-quality guidelines throughout the process of assessment of quality. Regarding oral migraine preventive medications, propranolol, metoprolol, flunarizine, sodium divalproex, and valproic acid are recommended to adult patients with episodic migraines based on high-quality evidence (“strong for”). Topiramate can be recommended for either episodic or chronic migraine (“strong for”). For migraine prevention using calcitonin gene-related peptide monoclonal antibodies, galcanezumab, fremanezumab, erenumab, and eptinezumab are recommended for adult patients with either episodic or chronic migraine on the basis of high-quality evidence (“strong for”). OnabotulinumtoxinA is recommended for adult patients with chronic migraine based on high-quality evidence (“strong for”). Last, frovatriptan, naratriptan, and zolmitriptan are recommended for short-term prevention in women with menstrual migraine (“strong for”).
Conclusion
In the present CPG, the authors provide specific, straightforward, and easy-to-implement evidence-based recommendations for pharmacologic migraine prevention. Nevertheless, these recommendations should be applied in real-world clinical practice based on optimal individualization.

Citations

Citations to this article as recorded by  
  • One-Year Compliance After Calcitonin Gene-Related Peptide Monoclonal Antibody Therapy for Migraine Patients in a Real-World Setting: A Multicenter Cross-Sectional Study
    Mi-kyoung Kang, Jong-Hee Sohn, Myoung-Jin Cha, Yoo Hwan Kim, Yooha Hong, Hee-Jin Im, Soo-Jin Cho
    Journal of Clinical Medicine.2025; 14(3): 734.     CrossRef
  • Beyond the Pain: Rethinking Migraine Care with the RELIEF PLAN Approach
    Sanghyo Ryu
    Headache and Pain Research.2025; 26(1): 1.     CrossRef
  • Concurrent Extracerebral Vasoconstriction in Patients with Reversible Cerebral Vasoconstriction Syndrome: A Cross-Sectional Study
    Byung-Su Kim, Sumin Kim, Eunhee Kim, Ick-Mo Chung, Sodam Jung, Yoonkyung Chang, Dong Woo Shin, Tae-Jin Song
    Journal of Clinical Medicine.2025; 14(13): 4402.     CrossRef
Case Report
Primary Headache Associated with Sexual Activity Presenting with Persistent Genital Arousal Disorder: A Case Report
Woo-Seok Ha, Hye-Kyung Baek
Headache Pain Res. 2024;25(2):117-121.   Published online September 2, 2024
DOI: https://doi.org/10.62087/hpr.2024.0012
  • 1,114 View
  • 23 Download
AbstractAbstract PDF
Persistent genital arousal disorder (PGAD) is characterized by unwanted and distressing genital sensations that are not associated with concomitant sexual interest or thoughts. Several etiologies have been proposed, but the underlying mechanism of the condition remains unclear. In this report, we describe a case of PGAD presenting with primary headache associated with sexual activity (PHASA). A 57-year-old female with no history of headache experienced recurrent, unwanted episodes of genital arousal lasting 3 to 5 days for 4 years. One day, she began to experience intense genital arousal that she had never experienced before. On the fourth day of arousal, while attempting intercourse with her partner, she experienced an abrupt explosive headache, which was repeated during another session of intercourse a week later. The patient underwent laboratory tests, as well as brain magnetic resonance imaging (MRI) and magnetic resonance angiography, all of which showed normal findings. She was referred to a sexual medicine specialist and prescribed amitriptyline, escitalopram, and propranolol with a diagnosis of PGAD. Her sexual arousal gradually diminished, and when she stopped all medications 3 months later, all symptoms had disappeared. On further investigation, spinal MRI revealed a Tarlov cyst. She has been in remission for three years. This case illustrates the co-occurrence of PHASA and PGAD and suggests a possible common pathophysiology shared between these two rare disorders.
Review Article
Application and Effectiveness of Dietary Therapies for Pediatric Migraine
Ji-Hoon Na
Headache Pain Res. 2024;25(1):34-41.   Published online April 17, 2024
DOI: https://doi.org/10.62087/hpr.2024.0007
  • 3,162 View
  • 65 Download
  • 6 Citations
AbstractAbstract PDF
Migraine is a representative type of primary headache and a common chronic neurological disease that accounts for a large proportion of headaches in children, adolescents, and adults. Unlike migraine in adulthood, pediatric migraine occurs when brain development is not yet complete. This characteristic may require a new perspective for the treatment and management of pediatric migraine. Dietary therapies, mainly the ketogenic diet and its variants, can have positive effects on pediatric migraine. Several recent studies have revealed that dietary therapies, such as the classic ketogenic diet, modified Atkins diet, and low glycemic index diet, improve various neurological diseases by improving dysbiosis of microbiota, reducing proinflammatory cytokines, and increasing mitochondrial function. Nonetheless, the mechanism through which active dietary therapy affects pediatric migraine requires further research. To achieve this, an important role is played by the neuro-nutritional team, which can develop and manage tolerable diets for pediatric migraine patients through mutual collaboration among pediatric neurologists, nurses, and nutritionists.

Citations

Citations to this article as recorded by  
  • Episodic Migraine in the Pediatric Population: Behavioral Therapies and other Non-Pharmacological Treatment Options
    Parisa Gazerani
    Current Pain and Headache Reports.2025;[Epub]     CrossRef
  • Current Trends in Pediatric Migraine: Clinical Insights and Therapeutic Strategies
    Adnan Khan, Sufang Liu, Feng Tao
    Brain Sciences.2025; 15(3): 280.     CrossRef
  • Clinical Efficacy and Safety of the Ketogenic Diet in Patients with Genetic Confirmation of Drug-Resistant Epilepsy
    Ji-Hoon Na, Hyunjoo Lee, Young-Mock Lee
    Nutrients.2025; 17(6): 979.     CrossRef
  • Clinical profile and treatment outcomes of idiopathic intracranial hypertension: a multicenter study from Korea
    Kyung-Hee Cho, Seol-Hee Baek, Sung-Hee Kim, Byung-Su Kim, Jong-Hee Sohn, Min Kyung Chu, Mi-Kyoung Kang, Hee Jung Mo, Sang-Hwa Lee, Hong-Kyun Park, Soohyun Cho, Sun-Young Oh, Jong-Geun Seo, Wonwoo Lee, Ju-Young Lee, Mi Ji Lee, Soo-Jin Cho
    The Journal of Headache and Pain.2024;[Epub]     CrossRef
  • Nutritional Approaches to Managing Pediatric Migraine
    Hye Eun Kwon
    Headache and Pain Research.2024; 25(2): 75.     CrossRef
  • Reduction of neck pain severity in patients with medication-overuse headache
    Yooha Hong, Hong-Kyun Park, Mi-Kyoung Kang, Sun-Young Oh, Jin-Ju Kang, Heui-Soo Moon, Tae-Jin Song, Mi Ji Lee, Min Kyung Chu, Soo-Jin Cho
    The Journal of Headache and Pain.2024;[Epub]     CrossRef
Original Article
Availability, Accessibility, and Utilization of Diagnostics and Therapeutics for Spontaneous Intracranial Hypotension in Asia
Soyoun Choi, Woo-Seok Ha, Soo-Jin Cho, Aynur Özge, Betül Baykan, Esme Ekizoglu, Kiratikorn Vongvaivanich, Koichi Hirata, Linh Tuyen Nguyen, Mamoru Shibata, Min Kyung Chu, Otgonbayar Luvsannorov, Ryotaro Ishii, Shengyuan Yu, Shih-Pin Chen, Shuu-Jiun Wang, Takao Takeshima, Tsubasa Takizawa, Vinh Khang Nguyen, Wei-Ta Chen, Yen-Feng Wang, Soo-Kyoung Kim, Mi Ji Lee
Headache Pain Res. 2025;26(2):142-153.   Published online June 16, 2025
DOI: https://doi.org/10.62087/hpr.2025.0005
  • 542 View
  • 12 Download
AbstractAbstract PDFSupplementary Material
Purpose: Recent advances in imaging techniques have significantly enhanced the diagnosis of spontaneous intracranial hypotension (SIH). However, these developments have been reported mostly in Europe and the United States. This study aimed to evaluate the availability and utilization of diagnostic and treatment modalities for SIH in Asia, through a survey of regional headache specialists.
Methods
A literature search was conducted using PubMed, and members of the Asian Regional Consortium for Headache were contacted. Participants completed a two-step survey evaluating the availability, accessibility, and frequency of SIH diagnostic and treatment methods in their countries and institutions. Descriptive statistics were used to analyze the data.
Results
Twenty physicians from eight countries completed both rounds of the survey. Lumbar puncture, brain magnetic resonance imaging (MRI), and spinal MRI are widely available across Asia, but real-time imaging techniques—such as dynamic computed tomography myelography and digital subtraction myelography—that precisely localize cerebrospinal fluid leaks are less accessible. Blind or semi-targeted epidural blood patches (EBPs) are available at most centers, but are easily accessible in only about half of cases. Surgical interventions are rarely available.
Conclusion
Most diagnostic methods for SIH are available in Asia, despite some regional disparities. The utilization of EBP and surgical interventions remains somewhat limited. This highlights the need for greater awareness and standardization of diagnostic methods in Asia.

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