- Pharmacological Treatment of Cluster Headache
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Soo-Jin Cho, Kyungmi Oh
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Published online December 31, 2013
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- 군발두통의 약물 치료
- 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.
- 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.
- 편두통 치료: 급성기 치료
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Kyungmi Oh
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Korean J Headache. 2009;10(1):14-18. Published online June 30, 2009
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- Migraine is a lifelong disabling recurring primary headache disorder. The ideal aims of acute therapy of migraine are rapid relief of pain and associating symptoms, no side effects, and no recurrence. Doctors should educate their patients to understand migraine before starting treatment. Furthermore, patients and doctors should discuss about their lifelong plan for migraine therapy. Many different medications have been used for acute therapy of migraine. But, only some drugs among them have sufficient evidence for use. I tried to review the strategies for acute treatment of migraine and introduce various medications for reducing migraine pain.
- Characteristics of Headache Sufferers Who Seeking a Tertiary Medical Care
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Kyungmi Oh, Byung-Jo Kim, Ki-Young Jung, Chin-Sang Chung
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Published online December 31, 2008
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- 3차 진료기관을 방문하는 두통 환자의 특징
- 편두통과 우-좌단락
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Kyungmi Oh, Chin-Sang Chung
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Korean J Headache. 2007;8(2):61-68. Published online December 31, 2007
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- The prevalence of migraine with aura in the general population is 12%, but was 3.5 times higher(42%) in patients with right-to-left shunt caused by patent foramen ovale, atrial septal defect, or pulmonary arteriovenous malformations. Many studies have reported the efficacy of percutaneous closure of shunt for reducing the prevalence of migraine with aura. However, a recent prospective controlled study did not show the efficacy of percutaneus shunt closure as a treatment of migraine. There are still many debating issues about this topic. The author would review that association of right-to-left shunt to migraine, relating phathophysiological mechanisms, and management of shunts in migraneurs.
- 증례 : 돌발 기침과 두통
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Kyungmi Oh, Seong-Cheol Cho, Byung-Jo Kim, Kun-Woo Park, Dae-Hie Lee
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Korean J Headache. 2006;7(2):106-108. Published online December 31, 2006
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- A 56-year-old man presented with a 40-day history of paroxysmal cough and hemicranial headaches occurring 5 to 10 times per day. The characteristic of headache was severe dull & aching nature in the left frontotemporal area for approximately 20 minutes. The headache attack was always accompanied concurrently by paroxysmal cough. Nasopharyngeal MRI revealed neck mass which encasing left cervical internal carotid artery and lower cranial nerves. Cough and headache, and other multiple lower cranial palsies were progressed and aggravated. We believe that the symptoms presented as simultaneous paroxysmal cough and headache might be related to mass lesion which stimulated vagus nerve.
- 베게너육아종증에서 보인 자두통
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Jeong-Yoon Choi, Kyungmi Oh, Ho-Jung Kim, Sang-Hyun Jang, Byung-Jo Kim
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Korean J Headache. 2006;7(1):53-56. Published online June 30, 2006
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- Secondary stabbing headache has been infrequently reported as a m anifestation of giant cell arteritis, intracranial aneurysm, cerebral atherosclerosis, or m eningioma. W egener's granulomatosis is a multi-system autoimmune disorder characterized by necrotizing granulomatous vasculitis predominantly in respiratory tract and kidney. H eadache is a very rare presenting symptom in these patients because m ost neurological symptoms are caused by involvem ent of peripheral nervous system. W e report a 61-year-old m an w ith stabbing headache as a presenting m anifestation of W egener's granulomatosis. Korean Journal of Headache 7(1):53-56, 2006
- 두통의 만성화 기전과 위험인자
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Kyungmi Oh
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Korean J Headache. 2006;7(1):4-11. Published online June 30, 2006
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- Chronic headache imposes considerable burdens on the sufferer and on society as w ell. Recent evidence suggests that migraine is a chronic and sometimes clinically progressive disorder characterized by recurrent episodes of headache. Indentifying risk factors for headache chronification and understanding of its mechanism help to establish intervention strategies on disease progression. In this article, I review the epidem iology of chronic daily headache, the em erging concepts of m igraine as a progressive disorder based on clinical evidences, the known risk factors for headache pro-gression, the reported m echanisms of m igraine chronification, and the treatm ent strategies that could reduce the burden of m igraine and possibly prevent disease progression. Korean Journal of Headache 7(1):4-11, 2006
- 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.
- 소아 편두통 증후군
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Kyungmi Oh
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Korean J Headache. 2004;5(1):23-32. Published online June 30, 2004
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- Recurrent primary headache is the most frequent neurological symptom at school age and the most frequent manifestation of pain in childhood. Migraine is one of the most common causes of headache resulting in missed school days and interfering with other daily activities. Prevalence of migraine is 3～10% in children. Clinical features and diagnostic criteria of childhood migraine differ from those in adult. The children and adolescents have attacks of shorter duration and bilateral location. This review intended to give an outline of general characteristics of childhood migraine. 'Childhood episodic synd- rome that are commonly precursors of migraine' according to International Classification of Headache Disorders, 2nd Edition(ICHD-II) includes cyclic vomiting, abdominal migraine, and benign paroxysmal vertigo of childhood. The clinical features and diagnostic criteria were described respectively. Other unclassi- fied episodic syndromes were introduced also. Korean Journal of Headache 5(1):23-32, 2004
- Evidence-Based Recommendations on Pharmacologic Treatment for Migraine Prevention: A Clinical Practice Guideline from the Korean Headache Society
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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
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Received June 23, 2024 Accepted September 11, 2024 Published online September 27, 2024
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DOI: https://doi.org/10.62087/hpr.2024.0019
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- 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.
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