- 수면과 두통
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Te Gyu Lee
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Korean J Headache. 2001;2(2):133-136. Published online December 31, 2001
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- Sleep is an important, but easily neglected issue in pain disorders, in both clinical and basic medical aspects. Many pain and headache disorders, such as fibromyalgia, small fiber neuropathy, cluster, migraine and hypnic headaches, are intimately related to disturbance in sleep physiology or circardian rhythm. Many pharmaceutical agents for pain, including tricyclic anti-depressants, also significantly affect sleep. Herein sleep medicine is reviewed for chronic pain management. Korean Journal of Headache 2(2):133-136, 2001
- 급성기 편두통 환자에서 Naratriptan 2.5mg의 이중맹검, 위약대조, 다기관 교차 투여 연구
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Yong-Woo Noh, Te Gyu Lee, Kyu-Hyun Park, Seung-Min Kim, Kyung-Cheon Chung
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Korean J Headache. 2001;2(1):53-60. Published online June 30, 2001
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- Background
Naratriptan is one of the new 'triptans' for the acute migraine treatment, but its effect for Asian patients is not known to our awareness. Methods: From December 1999 to November 2000, we studied the efficacy and safety of 2.5mg oral naratriptan with a randomized, placebo-controlled, cross-over, multi-center design in Korea. The study was implemented at the out-patient clinic in three university hospitals. For diagnosis of migraine, we used the Headache Classification proposed by the International Headache Society(1988). We randomly assigned 102 migraineurs, of whom 62 completed the study. The priamay endpoint was significant headache improvement after 4 hours of intervention, either 2.5mg naratriptan or placebo. Results: The rate of significant headache improvement after 4 hours is statistically higer with 2.5mg naratritan administration(56.7%) than with placebo(34.8%) (p=0.01). When 2.5mg oral narastriptan was administered, the clinical disability score was siginificantly improved after 1, 2, and 4 hours. There was no difference in adverse effects between naratriptan and placebo. With the relevant laboratory monitoring, naratriptan 2.5mg was safe at least in single oral dose. The headache recurrence rate after 24 hours, frequency of other medication use during migraine attacks, associate symptoms after 4 hours were better with naratriptan than placebo, but these were not statistically significant(p>0.05). Conclusion: Comparing to previous studies on randomized trials of naratriptan, the rate of signifianct headache improvement(56.7%) was slightly lower in our study. This may partly reflect racial genetic/neuropharmacological difference, such as serotonin receptors, in Asians. We suggest that 2.5mg oral naratriptan is effective and safe for the acute migraine treatment in Asians, as well as Cau- casians. Korean Journal of Headache 2(1):53-60, 2001
- 수면성 두통 증후군의 임상 양상과 병태생리적 기전
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Jeong Ho Ha, Sun Uck Kwon, Te Gyu Lee
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Korean J Headache. 2000;1(1):86-91. Published online June 30, 2000
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Abstract
- Hypnic headache syndrome is a rare headache disorder characterized by recurrent nocturnal attack at a consistent time that awaken the patients from sleep frequently. The pathophysiology is not well known, but a “perturbation of chronologic rhythm” and 'REM related phenomenon' have been suggested. We herein describe two patients with nocturnal headache compatible with a hypnic headache syndrome and the polysomnographic findings and discuss about the clinical features and the pathophysiology. Korean Journal of Headache 1(1):86-91, 2000
- 한국 성인에서의 편두통 유병률 연구
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Te Gyu Lee, Kyung Cheon Chung, Jae Wook Choi
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Korean J Headache. 2000;1(1):57-66. Published online June 30, 2000
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- Background
s: Since the International Headache Society(IHS) announced the classification and diag- nostic criteria for headache in 1988, migraine prevalence has been studied in many developed countries. However, no prevalence study of migraine with significant reliability is available in Korea hitherto. We believed the previous Korean study in 1998 was biased due to a very high rate of drop-out, thus revea- ling the world-highest prevalence rate of migraine since the IHS criteria was introduced. Methods: Among Koreans of 20 years old or more, we randomly selected about 1,500 target population by stratified random sampling with clustering, considering residential area, age, and gender. The headache questionnaire was designed to sort out headache and classify migraine based on the IHS classification and criteria for headache(1988). Results: Interviews using headache questionnaire and phone was sequen- tially conducted. The trained interviewers met the target individuals, then let him/her answer the questionnaire. If a target individual was not present during the inter- view period, a substitute candidate with the most similar demographic condition was interviewed in the same cluster area. A neurologist, expert in headache, gathered and analysed these data, then called target individuals if necessary to confirm whether(s)he has migraine or not. The number of target individuals was 1,523. There was no drop-out during questionnaire interviews. The investigator could not get phone interview with 17% of the target individuals who needed it. The overall migraine prevalence for last 12 months was 6.5%. The rate of migraine with aura was 1.3%, migraine without aura was 5.2%.(Male patients 3.2%, and females 9.7%). Prevalence of migrainous disorder was 5.9%. The fourth decade in life showed the highest prevalence(10.3%). Eigthy percent experienced difficulty in their school/job activities due to migraine. Two percent of the migraineurs occasionally visited emergency room for very severe migraine attacks. Conclusions: This study showed very similar results with those of Japanese and U.S. Asian studies. Among possible variables which determine migraine prevalence in a given population(country), genetic background seems to be the most influential. In conclusion, this is the first nationwide Korean study of migraine prevalence with good reliability and validity. Korean Journal of Headache 1(1):57-66, 2000
- 편두통과 세로토닌
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Te Gyu Lee
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Korean J Headache. 2000;1(1):15-17. Published online June 30, 2000
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- Serotonin seems to have an important role in migraine pathogenesis and treatment. It is abundant in the brain, intestinal mucosa and platelats, which are important in migraine symptomatology. Recently developed specific serotonin(5-HT1) agonists, namely “triptans” showed the way how to effectively treat acute migraine in view of serotonin hypothesis. Further development of specific receptor angonists and antagonists may well define receptor function and elucidate the validity of the serotonin hypothesis. Korean Journal of Headache 1(1):15-17, 2000
- 편두통과 Cortical Spreading Depression
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Te Gyu Lee
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Korean J Headache. 2000;1(1):6-14. Published online June 30, 2000
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- Cortical spreading depression(CSD) seems to be an important phenomenon explaining migraine aura. It occurs in four stages in animal model and starts from the occipital lobes, spreading forward on the cortical surfaces. Neuroimaging studies in migraineurs showed ictal blood flow changes compatible with CSD in the animal models. The brain stem nuclei(raphe and locus ceruleus) and cortical hyperexcitability may well have important role in generating CSD. Presence of CSD in migraine without aura remains controversial. The aura mechanisms in familial hemiplegic migraine and ophthalmoplegic migraine are also discussed. Korean Journal of Headache 1(1):6-14, 2000
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