- New Targeted Drugs for Acute Treatment of Migraine
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Heui-Soo Moon, Pil-Wook Chung, Byung-Kun Kim
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Korean J Headache. 2023;24(2):56-65. Published online December 31, 2023
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- Acute migraine treatments primarily aim to relieve headache pain and address accompanying symptoms such as photophobia, phonophobia, and nausea. Triptans have traditionally been the first-line treatment for moderate to severe migraine attacks. Nevertheless, they have several limitations, such as causing temporary vasoconstriction of blood vessels, contraindications in patients with cardiovascular issues, and distinctive side effects like chest tightness. Medication overuse is another concern with triptans, prompting research into new antimigraine drugs targeting calcitonin gene-related peptide (CGRP) or 5-HT1F receptors. Lasmiditan, an agonist at the 5-HT1F receptor, has emerged as a safe and effective option for abortive treatment in acute migraine attacks. It lacks the vasoconstrictive effects associated with triptans, making it a safer choice for individuals with contraindications to triptans. However, it may lead to central nervous system-related adverse effects, particularly dizziness and paresthesia. Gepants, which are CGRP antagonists, offer an innovative approach by targeting CGRP receptors which is believed to be central in migraine pathophysiology. These medications have demonstrated efficacy in alleviating migraine symptoms, providing alternatives to traditional treatments like triptans and ergots. Ubrogepant and rimegepant are the first approved oral gepants for acute migraine treatment, while Zavegepant is the first approved intranasal gepant. The most common treatment-related adverse events are gastrointestinal symptoms, including nausea. No vascular or hepatic concerns have emerged to date. In this review, we delve into the development of ditans and gepants for acute migraine treatment in adults and discuss their potential advantages and disadvantages in clinical use.
- Diagnostic Delay of Cluster Headache in Korea
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Byung-Su Kim, Soo-Kyoung Kim, Pil-Wook Chung, Byung-Kun Kim, Mi Ji Lee, Min Kyung Chu, Jin-Young Ahn, Dae Woong Bae, Tae-Jin Song
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Published online June 30, 2020
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- 국내 군발두통의 진단지연
- Characteristic Image Findings In A Patient With Deep Cerebral Venous Thrombosis Presented With Headache And Cognitive Decline
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Jung-Ju Lee, Ohyun Kwon, Jong Moo Park, Kyusik Kang, Woong-Woo Lee, Jung Whan Yoon, Byung-Kun Kim
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Published online June 30, 2018
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- 두통 및 인지기능장애를 보인 심부뇌정맥혈전증 환자의 특징적인 영상소견
- A Case of Superior Orbital Fissure Syndrome Attributed to Sinusitis Presenting Unilateral Throbbing Headache
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Byung-Su Kim, Byung-Kun Kim, Soo-Kyoung Kim, Jae-Moon Kim, Heui-Soo Moon, Kwang-Yeol Park, Jong-Hee Sohn, Tae-Jin Song, Min Kyung Chu, Myoung-Jin Cha, Soo-Jin Cho, J
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Published online December 31, 2017
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- 두통 초진 환자에서 이차두통의 임상적 예측인자: 다기관 연구
- The Frequency and Characteristics of Other Primary Headache Disorders in First-Visit Headache Patients in Korea: A Multicenter Study
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Myoung-Jin Cha, Byung-Kun Kim, Byung-Su Kim, Jong-Hee Sohn, Soo-Kyoung Kim, Heui-Soo Moon, Tae-Jin Song, Jae-Moon Kim, Jeong Wook Park, Min Kyung Chu, Kwang-Yeol Park
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Published online December 31, 2017
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- 신경과 외래를 방문한 두통 초진 환자에서 기타 원발두통의 빈도와 특징 - 다기관 연구
- Acute Ischemic Stroke with Prominent Headache Symptom: A Case Series Study
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Jae-Hyeok Heo, Min-Uk Jang, Byung-Kun Kim, Jin-Young Ahn
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Published online December 31, 2016
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- 두통을 주 증상으로 내원한 급성허혈뇌졸중: 증례 분석
- The Influence of Initial Headache as a Prognostic factor in Spinal Cord Decompression Sickness
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Dong-Gyu Lim, Hee-Tae Kim, Byung-Kun Kim, Jin-Young Ahn
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Published online December 31, 2016
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- 잠수 후 두통이 척수형 감압병 환자의 치료에 미치는 영향
- Aggravation by Routine Physical Activity and Associated Factors in the Korean Migraine Population
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Byung-Su Kim, Min Kyung Chu, Byung-Kun Kim, Jae-Moon Kim
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Published online June 30, 2015
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- 한국인 편두통 인구에서 일상신체활동에 의한 두통의 악화와 관련 인자
- 개연적 편두통과 편두통: 연속 질환 범주로서의 접근
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Gyoung Im Suh, Byung-Kun Kim, Min Kyung Chu, Soo-Jin Cho
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Published online December 31, 2012
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- A considerable proportion of individuals suffering from headache were classified as probable migraine, which is fulfilling all but one criterion for migraine. In the continuum severity theory, the mild end is thought to be tension type headache which transform into migraine with increasing severity of condition and the gray zone of headache occupies the middle ground of the continuum. Because of dichotomous diagnostic criteria between migraine and tension type headache, the position of probable migraine also could be located at this gray zone.
- 한국인구집단에서 체질량지수와 편두통: Korean Headache Survey 자료 분석
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Soo Hwan Yim, Byung-Kun Kim, Kwang-Soo Lee, Kyungmi Oh, Min Kyung Chu
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Korean J Headache. 2012;13(1):7-12. Published online June 30, 2012
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- Objective: Obesity and underweight are known to be exacerbating factors for migraine in Western countries. In Asian countries including Korea, migraine prevalence and body mass index (BMI) are often lower than Western countries. To investigate the relationship of BMI to the prevalence, frequency, duration and severity of migraine in Korea.
Methods
We selected a stratified random population sample of Koreans over age 18 and evaluated them with a 12-item semi-structured interview designed to identify headache type using ICHD-2 criteria. The participants were divided into 4 categories based on the World Health Organization BMI categories for Asian populations: underweight (<18.5), normal weight (18.5-22.9), overweight (23.0-24.9) and obese (≥25.0).
Results
Of 1,507 participants, 71 were underweight (4.8%), 768 had a normal BMI (51.3%), 326 were overweight (21.8%) and 330 were obese (22.1%). Prevalence varied by headache type for migraine (6.0%) and PM (11.5%). Migraine, prevalence did not vary with BMI, but migraine attack frequency per month was higher both in the underweight (8.6±9.1) and the obese groups (7.3±11.2) in comparison with the normal weighted (2.5±2.7). Duration of headache attack and pain intensity (VAS score) were not significantly different between these groups.
Conclusions
In Koreans, obesity and underweight are associated with migraine attack frequency.
- 한국인구집단에서 편두통환자의 냄새공포증과 편두통 대체진단기준의 타당도 평가
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Yeo Jin Kim, Soo-Jin Cho, Byung-Kun Kim, Kwang-Soo Lee, Byung-Chul Lee, Min Kyung Chu
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Korean J Headache. 2011;12(2):91-96. Published online December 31, 2011
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- Objective: Osmophobia, intolerance to smell, is often reported by migraine patients during headache attack and is included as an item of alternative diagnostic criteria for migraine in the appendix of ICHD-2. Most of previous reports on osmo- phobia were hospital-based studies and osmphobia of migraineurs across population sample was not reported yet. The aims of this study are to assess osmophobia in migraineurs across Korean populationand to assess validity of alternative diagnostic criteria of migraine. Methods: We used data of Korean Headache Survey(KHS), a population-based study by a stratified random sampling in Korean population over age 19, and totally 1,507 were evaluated. Demographic profile, headache characteristics and impact of headache were assessed with a 12-item semi-structured interview. Headache type was identified according to ICHD-2. We assessed osmophobia by a question ‘Do you feel changes in your sense of smell during headache?(stronger or differently)’. Results: Prevalence for migraine was 6.1%. 50.5% of migraineurs reported osmophobia during migraine attack. Mig- raineurs with osmophobia had more headache aggravation by routine physical activity, phonophobia and higher HIT-6 score than migraineurs without osmophobia. There were no significant difference in unilaterality of pain, pain intensity in VAS score, pulsating quality and photophobia between migraineurs with osmophobia and migraineurs without osmo- phobia. The sensitivity of alternative criteria was 0.95[95% confidence interval(CI), 0.87-0.98] and specificity was 0.99(95% CI, 0.98-0.99). Conclusions: Approximately half of migraineurs across Korean population sample reported osmophobia. Alternative criteria showed good specificity and sensitivity.
- 원발벼락두통의 임상양상
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Jiyeon Kim, Byung-Kun Kim, Gun-Sei Oh, Jae Myun Chung, Kyungmi Oh, Jeong Wook Park, Soo-Jin Cho
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Korean J Headache. 2011;12(2):85-90. Published online December 31, 2011
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- Objective: Thunderclap headache is a sign of a medical emergency such as a life-threatening subarachnoid hemorrhage (SAH). However, it also may occur in primary headache conditions such as cough, physical exertion, sexual activity and even without any provoking factors. International Headache Society classified thunderclap headache disorders into four different subtypes: (1) primary thunderclap headache(PTH); (2) primary cough headache(PCH); (3) primary exertional headache (PEH); and (4) primary headache associated with sexual activity(PSH). Subtypes of thunderclap headaches are reported to share many common characteristics, although studies on the clinical features and triggering factors of thunderclap headaches are limited. Methods: Seventy and two patients with thunderclap headache were prospectively enrolled from March 2008 to June 2010. The patients presented sudden severe headaches, reaching maximal intensity within 1 minute, without focal neu- rologic deficit. SAH and other organic disorders were excluded in this study. We described clinical features, triggering factors and vasospasm, and compared between the four subtypes of thunderclap headache. Results: Of the 72 recruited patients, PTH(n=25, 34.7%) was the most frequent thunderclap headache subtype, followed by PCH(n=23, 31.9%), PSH(n=15, 20.1%) and PEH(n=9, 12.5%). 49(68.1%) patients suffered recurrent thunderclap head- ache attacks at presentation. 49(68.1%) patients had more than one provoking factor. Defecation(n=13, 16.0%) was the most frequent provoking factor followed by sexual intercourse(n=11, 13.7%). Mean age was 45.1±12.6 years(range: 15-70). PEH group (36.6 years old) was younger than other groups. Overall male to female ratio in this study was 1:1.7. Mean duration of headache was 40.7±56.3 minutes(range: 0.17-720). The headache duration was shorter in PEH(25.2±14.2 minutes) than other groups. Vasospasm was documented in 10 patients(13.9%). Conclusions: More than two-thirds of patients with thunderclap headache have more than one provoking factor at presentation. Contrary to the previous studies, vasospasm was associated in small proportion of patients.
- 한국인 인구집단에서 교육수준이 긴장형두통의 유병률에 미치는 영향
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Dong-Won Lee, Yang-Ki Minn, Min Kyung Chu, Kyung-Mi Oh, Byung-Kun Kim, Kwang Soo Lee, Soo-Jin Cho
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Korean J Headache. 2011;12(1):57-60. Published online June 30, 2011
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- Objective: Education reflects socioeconomic status and may influence pain modulation or thresholds in primary headache disorders. Tension-type headache(TTH) is the most common type of primary headache and the influence of education on the prevalence of TTH has not been well evaluated. The aims of this study were to evaluate the asso- ciation between education level and the prevalence of TTH and the influence of other contributors. Methods: For this study, a stratified random population sample of Koreans, over the age of 19, was selected and evalua- ted using a 12-item, semi-structured interview designed to identify headache type using ICHD-2 criteria. Education levels were classified into college, high school, and middle school or below. Household income and occupation were evaluated as contributors. Results: Among 1507 participants, 463(30.7%) were diagnosed with TTH; 228 were frequent episodic TTH, 224 were infrequent episodic TTH, and 11 were chronic TTH. College level was associated with a lower prevalence of tension-type headache(25.8% vs 33.8% in high school, 32.9% in middle school or below, p=0.006). Prevalence of frequent episodic TTH was lower in college graduate(p=0.002). After adjusting age, gender, and income, education level is the significant contributor for prevalence of TTH. Conclusions: Among variables of socioeconomic status, education is the important modulator of TTH, especially in women.
- 한국인 인구집단에서 고빈도 삽화성 긴장형두통의 영향
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Soo-Jin Cho, Min Kyung Chu, Byung-Kun Kim, Jae-Myun Chung, Kwang Soo Lee
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Korean J Headache. 2010;11(2):91-94. Published online December 31, 2010
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- Background
Frequent episodic tension-type headache (ETTH) is a subtype of tension-type headache (TTH) based upon ICHD-2 criteria. ETTH is generally considered as mild primary headache disorder but the impact of frequent ETTH has not been evaluated separately from infrequent ETTH. Therefore, this study evaluated the impact of frequent ETTH. Method: For this study, a stratified random population sample of Koreans, over the age of 19, was selected and evaluated using a 12-item, semi-structured interview designed to identify headache type using ICHD-2 criteria. The burden of the headache was evaluated by the headache impact test-6 (HIT-6). Results: Among 1507 participants, 463 (30.7%) were diagnosed with TTH; 228 were diagnosed with frequent ETTH, 224 were infrequent ETTH, and 11 were chronic TTH. Thirty-two patients (6.9%) with TTH had substantial to severe impact in HIT-6 (≥56); 22 had frequent ETTH, 7 had infrequent TTH, and 3 had chronic TTH (p<0.01). Frequent TTH, severity of pain by visual analogue scales, aggravation with physical activity, moderate or severe intensity, and phonophobia influenced on total scores of HIT-6. Conclusion: Frequent ETTH is a common headache disorder and had significant impact, so medical and social attentions are promptly needed.
- 두통질환에서의 약물 연구
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Byung-Kun Kim
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Korean J Headache. 2010;11(1):13-16. Published online June 30, 2010
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- In 1991 the Clinical Trials Subcommittee of the International Headache Society(IHS) published its first edition of the guidelines on controlled trials of drugs in migraine. The guidelines were developed because of a need to improve the quality of controlled clinical trials in migraine and to draw investigator’s attention to the problems inherent in drug trials in migraine. In this article, I will briefly review the guidelines of migraine, tension-type headache and cluster headache.
- Tolosa-Hunt Syndrome Complicating Idiopathic Hypertrophic Pachymeningitis: Case Report and Consideration About its Pathogenesis
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Suntae Hwang, Nayoung Kim, Byung-Kun Kim, Jasung Koo, Jong-Moo Park, Jung Ju Lee, Ohyun Kwon
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Published online December 31, 2008
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- Tolosa-Hunt Syndrome Complicating Idiopathic Hypertrophic Pachymeningitis: Case Report and Consideration About its Pathogenesis
- 편두통과 어지럼
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Byung-Kun Kim
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Korean J Headache. 2006;7(1):12-22. Published online June 30, 2006
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- Patients w ith m igraine frequently have hypersensitivity to light, sound, and smell. In addition to these hallmark features of m igraine, patients often describe vestibular complaints ranging from frank vertigo to less specific symptoms of dizziness, unsteadiness, and head m otion intolerance. O ver the last two decades a number of studies have stressed the association of m igraine with vestibular and ocular m otor disorders. M igraine m ay be a m ost common cause of various forms of episodic vertigo, but definite diagnostic criteria for m igraine related vertigo are still lacking. A review of the literature on this chapter demonstrates the difficulties in pinpointing migraine-related vertigo as a clearly defined entity. The interrelations of migraine and dizziness can be classified into seven categories: ① vertigo as an aura of m igraine-basilar type m igraine, ② episodic vertigo attack w ithout typical temporal relationship to migraine headache - m igraine equivalent, ③ Vertigo/dizziness during m igraine attack, ④ susceptibility of motion sickness in m igraine patients, ⑤ CACNA1A gene m utation and migraine-familial hemiplegic migraine, episodic ataxia type 2, ⑥ well defined vertigo syndromes that are not caused by migraine but show a statistical association w ith m igraine-Meniere disease, BPPV, ⑦ non-vestibular dizziness in m igraine patients-psychiatric comorbidity, antim igraine m edication. Each part of categories will be discussed. Korean Journal of Headache 7(1):12-22, 2006
- 한국에서 편두통 예방 치료를 위한 평가 - 편두통에 의한 장애인식 캠페인 -
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Min-Kyung Chu, Sun Uck Kwon, Manho Kim, Byung-Kun Kim, Byung-Joo Kim, Yeong-In Kim, Yong-Jae Kim, Won-Joo Kim, Jae-Moon Kim, Hyun Sook Kim, Jin Kuk Do, Ki-Jong Park@
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Korean J Headache. 2005;6(2):121-128. Published online December 31, 2005
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- Background
Migraine is a common, disabling illness and imposes great burden on society. Migraine- related disability is often poorly communicated between patients and physicians. The prevalence, disability and medical service utilization behavior of migraine has not been evaluated sufficiently in Korea. The goal of this study is to determine the proportion of migraine among patients presented with headache in neurology clinic and to assess the level of headache related disability of patients.
Methods
This survey recruited patients who consulted to neurologists with a chief complaint of headache in 17 hospitals in Korea. Patients answered a self-administered questionnaire. The investigators independently responded another questionnaire about their patients' headache and assessed headache related disabilities after diagnostic interview. Patients suffering from headache ≥15 days per month were excluded.
Results
Among 570 patients (female 433 (76.0%), mean age 47.8±15.6) who responded adequately the questionnaire, 376 patients had migraine. Fifty-eight percent of the migraine patients were newly diagnosed as having migraine through this survey. However, 74.9% of migraineurs have taken pain-relieving drugs when headache developed; 12.3% of the migraineurs overused the medications. One hundred forty one (37.5%) migraineurs reported that they miss family, social and leisure activities because of headache. Thirty percents of migraineurs were on prophylactic medications and 14.4% of them have visited emergency room due to severe headache. The neurologists would recommend prophylactic medication in 64.3% of patients who were not on prophylaxis.
Conclusions
This study showed that migraine is the most common headache syndrome in the neu- rology clinics of Korea. Significant portion of the migraine patients have migraine-related disability. A majority of migraineurs exposed pain-relieving drugs without exact diagnosis and some of them overused them. Korean Journal of Headache 6(2):121-128, 2005
- 일반연제-Clinical Characteristics of Migraine and Tension-type Headache: The Experience in Eulji Hospital
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Byung-Kun Kim, Hee-Jun Bae, Ja-Seong Koo, Oh-Hyun Kwon , Jong-Moo Park
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Korean J Headache. 2005;6(1):103-103. Published online June 30, 2005
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- Objectives
To analyze the epidemiological and clinical characteristics of migraine and tension-type headache(TTH) in secondary general hospital. Methods: Between January 2004 and April 2005, 625 patients(age, mean=42.7 years, ranging from 14 to 79 years; 454 women and 171men), who presented with headache as chief complaints, were recruited prospec- tively. Information on epidemiological and clinical characteristics was collected from the structured questionnaire and registry. The criteria defined by the International Headache Society were used in the diagnosis. A total of 95% of the patients had primary headache: migraine(26.9%, mean age±SD=36.0±11.4 years, 148 women and 20 men), probable migraine(5.1%), episodic TTH(21.3% mean age±SD=45.6±14.2 years, 89 women and 44 men), probable episodic TTH(6.6%), primary chronic daily headache which includes chronic migraine, chronic TTH, hemicrania continua, and new daily-persistent headache(19.4%), and other primary headache(15.7%). We analyze the clinical characteristics of migraine (except chronic migraine) and episodic TTH. Results: Sixteen patients(9.5%) of those with migraine had migraine with aura. The mean age at onset was 24.6±9.2 years in migraine and 37.9±14.5 years in TTH(p<0.05). Female sex was more prevalent in migraine (p<0.05). Migraine headaches were unilateral(57%), pulsating(52%), aggravated by physical activity(80%), and were accompanied by vomiting(58%), photophobia(70%), and phonophobia(76%). TTH were unilateral(55%), pulsating(18%), aggravated by physical activity(23%), and were occasionally accom- panied by photophobia(22%) and phonophobia(33%). The most frequently reported trigger factors for migraine were stress(82%), fatigue(72%), menstruation(36% of women), alcohol(30%), cold or hot weather(27%), missing a meal(24%), weekend(13%), overeating(12%), and food(7%). The most frequently reported trigger factors for TTH were stress(77%), fatigue (62%), missing a meal(20%), cold or hot weather(18%), alcohol(17%), menstruation(11% of women), overeating (8%), weekend(5%), and food(5%). Patients with migraine had a greater prevalence(p<0.05) of medication overuse history. Beck depression inventory score was not different between migraine(22.0±4.8) and TTH(23.4±5.8). Beck anxiety inventory score was significantly higher in TTH group(p<0.05). Sixty percent of migraineurs and 55% of patients with TTH reported receiving a physician diagnosis of headache. However, only 21% of migraineurs and 29% of patients with TTH received a diagnosis of their headache correctly. Sixty-five percent of misdiagnosed migraineurs reported a diagnosis of TTH. Thirty-one percent of misdiagnosed patients with TTH reported a diagnosis of migraine. Conclusions: Migraine and TTH are a common cause of recurrent headache in secondary general hos- pital. Stress and fatigue were most frequent triggering factors for both headache types. Prevalence of depression and unilaterality of headache is not different between two groups. Migraine most frequently misdiagnosed as TTH.
- 일반연제-Photophobia in Korean Patients with Migraine
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Kyungmi Oh, Byung-Kun Kim, Byung-Jo Kim, Jin-Kyu Han, Kun-Woo Park , Dae-Hie Lee
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Korean J Headache. 2005;6(1):102-102. Published online June 30, 2005
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- Background
Although photophobia is a main component of migraine classification and ID-migraine, previous literature reported lower incidence rate(about 40%) in Korean patients with migraine than inte- rnational studies with Caucasian patients Objectives: This study was performed to compare the photophobia incidence rate detected by simple interview in Korean migraineurs with that detected by a specific photophobia questionnaire. Methods: Seventy-four migraine patients with mean age of 39.8±17.36 years were enrolled in this study. After simple interview by a headache specialist, patients were asked to report the questionnaire, which is comprised of 8 items. Seven items are questions about various symptoms, avoidance and as a triggering factor related to light during migraine attacks, and one item is a question if the symptom occurs during interictal period. Results: A total of 40(54.1%) patients noted photophobia through the simple interview, and all of them reported yes to at least 1 item in the questionnaire. Fifty-three(85.1%) patients were revealed as having photophobia by the questionnaire. Of these 53 patients, 23 had same symptoms in headache-free period. Conclusion: Similar photophobia incidence with Caucasian was revealed by the questionnaire. The questionnaire may be used as sensitive method to help detect photophobia in Korean.
- 편두통과 연관된 어지럼
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Byung-Kun Kim
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Korean J Headache. 2004;5(1):33-42. Published online June 30, 2004
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- Over the last two decades a number of studies have stressed the association of migraine with vestibular and ocular motor disorders. Migraine may be a most common cause of various forms of episodic vertigo. The interrelations of migraine and dizziness can be classified into seven categories: ① vertigo as an aura of migraine-basilar type migraine, ② episodic vertigo attack without typical temporal relationship to migraine headache-migraine equivalent, ③ Vertigo/dizziness during migraine attack, ④ susceptibility of motion sickness in migraine patients, ⑤ CACNA1A gene mutation and migraine-familial hemiplegic migraine, episodic ataxia type 2, ⑥ well defined vertigo syndromes that are not caused by migraine but show a statistical association with migraine-Meniere's disease, BPPV, ⑦ non-vestibular dizziness in mi- graine patients-psychiatric comorbidity, antimigraine medication. Each part of categories will be discussed. Korean Journal of Headache 5(1):33-42, 2004
- 한국인 편두통 환자와 미토콘드리아 DNA 11,084 유전자 다형성의 연관성
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Byung-Kun Kim, Hee-Joon Bae, Ja-Seong Koo, Oh-Hyun Kwon, Man-Ho Kim
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Korean J Headache. 2002;3(2):111-115. Published online December 31, 2002
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- Background
The genetic and molecular basis of migraine is still unknown. Clinical similarities bet- ween migraine and mitochondrial encephalomyopathies and the bias toward maternal transmission in family studies suggest that mitochondrial DNA(mtDNA) may play a role in migraine pathogenesis. An A-11,084-G substitution at mtDNA, has been reported in 25% of Japanese migraineurs. In contrast, in Danish individuals, this A-to-G mutation at mtDNA 11,084 was detected neither in persons with mig- raine nor in persons who had never had migraine. The aim of the present study was to investigate the frequency of this mutation in Korean migraineurs. Methods: One hundred migraineurs were studied after obtaining informed consent. A diagnosis of migraine was made on the basis of the International Headache Society criteria. DNA was purified from whole blood using DNA purification kit. For the analysis of mitochondrial nucleotide A-11,084-G substi- tution, mtDNA(bases 10,835 to 11,236) was amplified by polymerase chain reaction(PCR) using primers described previously. An A-11,084-G substitution generates BsmI restriction site. BsmI site containing PCR product(13,031～13,610 bases) was also amplified for positive-control. The amplified products were digested with 1 unit of BsmI, and were sized on a 1% TAE agarose gel with 100-bp DNA ladder marker. Results: None of the PCR products were cleaved by BsmI, whereas the positive controls were all digested by BsmI. We failed to detect the mtDNA A-11084-G substitution in our Korean patients with migraine. Conclusions: Mitochondrial DNA A to G polymorphism at 11,084 is not a risk factor for Korean mig- raineurs. This mutation may be rare in non-Japanese populations, which suggests ethnic difference in SNP genotype. Korean Journal of Headache 3(2):111-115, 2002
- 특발성 자두통의 임상 양상
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Byung-Kun Kim, Hee-Joon Bae, Ja-Seong Koo, Oh-Hyun Kwon
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Korean J Headache. 2002;3(2):99-104. Published online December 31, 2002
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- Background
Although idiopathic stabbing headache(ISH) seems to be very common primary head- ache with unique clinical features, previous descriptions about ISH were rather confusing. The classi- fication of the International Headache Society emphasized pain location confined to the distribution of the first division of the trigeminal nerve. Other terms describing ISH, such as ice-pick like pain, jab and jolts syndrome, sharp short lived head pain syndrome and ophthalmodynia, had some different clinical features each other. ISH also have been described in conjunction with migraine or cluster headache. However, in clinical practice, ISH occurs more frequently in extra-trigeminal region and is usually not associated with other primary headache syndromes. Methods: From Feb 2001 to August 2001, 1126 consecutive series of patients suffering from headache were examined in our neurology out-patients clinics. Among the patients, 50 patients presented stabbing headache with chief complaints. This sample consisted 21 males and 29 females aged from 12 to 79 years. Inclusion criteria were: (a) manifesting recurrent stabs on the head as a chief complaint, (b) wit- hout other organic causes. Results: The pain was more frequently localized extratrigeminal area(parietal, retroauricular or occipital) (60%), less frequently in the trigeminal area(20%), or both(20%). The orbital region was never affected. Regarding other coexisting forms of headache, only 20% suffered from other types of head- ache(migraine 6%, tension type headache 14%). No body had the associated autonomic features. In most patients(64%), the paroxysms lasted only 1～2s. The maximal frequency of attacks was variable, ranging from several tens to hundreds for one day. ISH was lasted from 1 to 36 days(mean 9.2±6.7 days). Conclusions: Our results show that the clinical features of ISH are somewhat different from previous studies by its location and its lack of association with migraine or cluster. All had benign course. Korean Journal of Headache 3(2):99-104, 2002
- 만성 두통의 분류: Transcranial Doppler를 이용한 혈류역학적 접근
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Byung-Kun Kim, Hee-Joon Bae, Ja-Seong Koo
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Korean J Headache. 2001;2(1):41-47. Published online June 30, 2001
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Abstract
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- Background
s: The International Headache Society(IHS) headache classification, while widely used throughout the world, has a problem in the definition and classification of the daily and near-daily headache named chronic daily headache(CDH). According to the IHS criteria, a chronic tension-type headache(CTTH) is the only possible diagnosis in patients with CDH. Although several studies have demonstrated that many patients with CDH originally suffered from migraine and their headache has transformed from migraine into a CDH(this type of headache was called transformed migraine: TM), the nosological entity of TM is still disputed. Objective: To demonstrate that TM and CTTH have different pathogenesis, we investigated the cerebral hemodynamics of TM and CTTH by using transcranial Doppler (TCD). Methods: During 6 months, 33 patients with TM and 33 with CTTH, diagnosed according to the second revision of IHS criteria proposed by Silberstein, et al., were gathered. TCD was performed with standard methods to measure the mean flow velocities(MFV) and pulsatile indices(PI) of middle cerebral, anterior cerebral, posterior cerebral, vertebral, distal and proximal basilar, ophthalmic artery, and distal, proximal and siphon portion of internal carotid artery. MFV and PI of TM were compared with those of CTTH by student's t test. Results: MFV of all examined arteries in TM were higher than those in CTTH. The differences in MFV were statistically significant in middle cerebral(p=0.005), anterior cerebral(p=0.05), vertebral(p=0.007), distal internal carotid(p=0.003) and proximal internal carotid artery (p=0.04), respectively. Though there was no statistically significant difference, PI of most arteries were lower in TM than in CTTH. Conclusions: Our results show that the cerebral hemodynamic features of TM are clearly different from those of CTTH. Therefore, we propose that TM should be included as a separate disease entity in the next edition of the IHS classification. Korean Journal of Headache 2(1):41-47, 2001
- 만성 두통 환자의 분류
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Byung-Kun Kim, Hee-Joon Bae, Ja-Seong Koo
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Korean J Headache. 2000;1(1):67-73. Published online June 30, 2000
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Abstract
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- Background
s: Although daily and near-daily headache named chronic daily headache(CDH) is an important reason for consultation in headache clinics, the International Headache Society(IHS) headache classification has a problem in the definition and classi-fication of the CDH. This fact led Silberstein et al in 1996 to propose revised criteria for CDH. They subdivided CDH into transformed migraine(TM), chronic tension type headache(CTTH), hemicrania continua(HC), and new daily persistent headache (NDPH). The objective of the present study was to prospectively classify CDH into subtypes according to the revised criteria for CDH and evaluate the effectiveness of new classification. Methods: We used structured questionnaire and clinical interview to make diagnosis of headache. Subject who had headaches more than 15 headache days a month considered to have CDH. CDH was further classified into TM, CTTH, HC, and NDPH according to the second revision of IHS criteria proposed by Silberstein, et al. Results: During 9 months, we studied 193 consecutive outpatients with CDH. The average age of these patients was 46 years. One hundred sixty-four patients(85.0%) were women. Eighty-nine(46.1%) had CTTH. TM was diagnosed in 90(46.6%). The 3 cases(1.6%) in this series met the criteria of NDDH. However the remaining 11 cases(5.7%) were not classifiable. No one was diagnosed as having HC. Analgesic overuse was reported in 24.4% of cases. Conclusions: Although most of patients with CDH had CTTH or TM, we were still not able to classify all the CDH. Therefore, we propose that modifica- tion of this classification system is needed. Korean Journal of Headache 1(1):67-73, 2000
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