- 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.
- 편두통 예방치료 약물
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Jae-Myun Chung
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Korean J Headache. 2010;11(1):42-49. Published online June 30, 2010
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- Migraine is a common and disabling recurrent headache disorder. Its burden on individual's quality of life makes migraine to be a serious health problem. Preventive pharmacological treatment is one of major categories in migraine treatment along with acute and nonpharmacologic managements. Preventive treatment is required in those with fre- quent or disabling attacks of migraine to minimize the disability, to prevent medication overuse, and to improve the quality of life. Beta blockers, of which propranolol is the representative, are the most reliable preventive drugs of proven efficacy. Amitriptyline is also a reliable migraine preventive drug in antidepressants in spite of newer drugs such as SSRI or SNRI came to practice. Neuromodulators including valproic acid and topiramate are expected to be used more in the future based on their mechanism of action. All practitioners also should keep in mind several points considered in preventive managements, such as efficacy of drugs, comorbidities and duration of prophylaxis.
- 난치성 두통의 치료
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Jae-Myun Chung
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Korean J Headache. 2009;10(2):124-129. Published online December 31, 2009
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- Refractory headache is the most troublesome problem in headache clinic. In spite of its frequent encounter in clinical practice, the definition of "refractoriness" started to be discussed recently. Operational definition of refractory migraine and refractory chronic migraine has been suggested for clinical and basic research purpose although debates exists. Pathogenetic mechanisms of refractory headache are also being unveiled nowadays, including genetic causes and structural changes. In clinical practice, many of the patients having refractory headache might be successfully managed with basic principles. These include correct disgnosis, attention to medication-overuse or comorbid illness, proper optimized acute and preventive pharmacologic treatments, and nonpharmacological lifestyle modifications.
- 편두통 예방치료
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Jae-Myun Chung, Min-Kyung Chu
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Korean J Headache. 2009;10(1):19-34. Published online June 30, 2009
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- Migraine is a chronic recurrent headache disorder that is common in general population. Its burden of socioeconomical aspect as well as personal psychologic aspect makes migraine as one of the most disabling disorders. In addition to acute treatment of migraine, preventive treatment is required in those with frequent or disabling attacks of migraine to minimize the disability, to prevent medication overuse, and to improve the quality of life. In this review, we discuss the principles of migraine prevention, and clinical applications of medications for this purpose which include beta blockers, calcium channel blockers, antidepressants and anticonvulsants as well as newly emerging drugs such as angiotensin-converting enzyme inhibitor, angiotensin-receptor blocker, coenzyme Q10, riboflavin and magnesium. Nonpharmacologic management for migraine prevention is an another important treatment strategy. Considering underdiagnosis and undertreatment of migraine, the knowledge about applying appropriate preventive management is essential for any physician irrespective of specialty.
- 자가편두통 선별 도구의 개발 및 타당도 평가 -한국 편두통 선별 설문-
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Min-Kyung Chu, Byung Kun Kim, Sung Taek Kim, Jae-Moon Kim, Heui-Soo Moon, Jeong Wook Park, Kwang-Soo Lee, Kyung-Mi Oh, Jae-Myun Chung, Chin-Sang Chunge
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Korean J Headache. 2007;8(2):84-91. Published online December 31, 2007
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- Background
Migraine is a common and disabling illness. But substantial migraine sufferers were underdiagnosed or undiagnosed. To improve migraine diagnosis, Korean Migraine Screening Questionnaire(KMSQ) was developed and validated in outpatient setting. Methods: A total of 507 patients who visited out patient clinic for headache were recruited in 10 hospitals in Korea and asked 10-item questionnaire concerning headache. 487 completed and returned the questionnaire. All patients were evaluated for headache and diagnosed by headache experts. Migraine diagnosis was assigned on International Head- ache Society(IHS) criteria after completing semi-structured diagnostic interview. Results: Of ten diagnostic questions derived from IHS criteria and headache expert experience, three-item subsets were deduced. Combination of questions regarding nausea, pulsating quality and photophobia showed optimum perfor- mances. Any two from the three items showed a sensitivity of 0.74, a specificity of 0.80, a positive predictive value of 80.8 and a negative predictive value of 73.5. Conclusion: The three-item Korean Migraine Screening Questionnaire was a valid and reliable migraine screening instru- ment in outpatient setting. It could help in improvement of migraine diagnosis and enhance migraine management.
- 만성매일두통의 치료
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Jae-Myun Chung
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Korean J Headache. 2007;8(1):6-11. Published online June 30, 2007
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- hronic daily headache characteristically develops headaches more than 15 days per month. This is not a disease entity but a syndrome which encompasses various primary and secondary headaches, and usually associated with medication overuse. Chronic daily headache is common as 3～5% of general population suffer, and causes profound disability which makes patients' quality of life miserable. Proper strategy of prevention and treatment of chronic daily headache is important because it makes prophylactic management useful and blocks perpetuation of headache. This review summarizes recent advances in management of chronic daily headache with a focus on the treatment of medication- overuse headache.
- 편두통 급성기 치료의 비특이 약물들
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Jae-Myun Chung
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Korean J Headache. 2005;6(1):21-25. Published online June 30, 2005
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- Migraine as a chronic, intermittent disabling condition affects physical, mental, and social quality of life. Among various medications being used in acute treatment of migraine, analgesics, nonsteroidal antiinflam- matory drugs(NSAIDs), antiemetics, and opioids constitute nonspecific treatment. Analgesics and NSAIDs are the mainstay of the self-administered treatment options in many migraineurs, and thus have a huge influence on their migraine status, even make them suffer from medication-overuse headache. Antiemetics, especially metoclopramide exert ancillary effect for rapid absorption of other anti-migraine drugs as well as anti-migraine effect by itself. Opioids can be used as a rescue medicine only in special circumstances because of its addictive feature. These nonspecific acute anti-migraine medications should be used accor- ding to practice guideline so that could enhance patients' quality of life. Korean Journal of Headache 6(1):21-25, 2005
- 급성기 편두통 치료의 최근 경향
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Jae-Myun Chung
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Korean J Headache. 2003;4(1):30-36. Published online June 30, 2003
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- Migraine is becoming to be recognized as one of the most significant health burden to people as well as one of the most challenging clinical problem to clinicians. Since the role of serotonin in the patho- genesis of migraine was established, there have been leaping advances in migraine therapy which were in conjunction with the advent of sumatriptan followed by various second generation triptans. Nowadays what agent clinicians should select in acute treatment of various migraines is changing in relation to such advances. In this review, the author described recent trends in acute migraine therapy with stress on evidence-based guideline for migraine headache published by the Quality Standards Subcommittee of the American Academy of Neurology in company with some remarks on the various triptans. Korean Journal of Headache 4(1):30-36, 2003
- 편두통 환자에서 이중 자극 순목 반사
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Jae-Myun Chung, Kyung-Seok Park
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Korean J Headache. 2002;3(2):105-109. Published online December 31, 2002
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- Background
Background: Trigeminovascular system is widely accepted hypothesis as an explanation for migraine pathogenesis. And the trigeminal nucleus in this system is believed to do a pivotal role. Recovery characteristics of R2 response to paired stimulations in blink reflex study is a practical and useful investigating tool for afferent trigeminal pathway as well as efferent facial nerve. Methods: We studied whether any difference in R2 recovery after paired stimulations is present between 9 patients of migraine without aura(MOA) and 9 migraine with aura(MWA) patients. Results: There was a difference in R2 recovery characteristics to paired stimulation between migraine patients and control group at interstimulus interval(ISI) of 0.3 sec. However, there was no difference between patients of MOA and MWA at each ISI. Conclusion: Although this study shows the possibility that at least the head pain mechanism in both MOA and MWA shares a common mechanism, more refined future study for larger number of cases is needed to confirm. Korean Journal of Headache 3(2):105-109, 2002
- 흔하지 않은 편두통
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Jae-Myun Chung
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Korean J Headache. 2002;3(1):31-38. Published online June 30, 2002
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