Headache and Pain Research

Volume 13(1); June 2012

만성편두통에서 돌외추출물의 효과와 안정성: 무작위, 이중맹검, 위약대조법을 이용한 연구: Seong-Hae Jeong, Jae-Moon Kim, Mi Sook Park, Myung Koo Lee; Korean J Headache. 2012;13(1):1-6. Published online June 30, 2012

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Abstract PDF: Objective: To evaluate the clinical efficacy and safety of a standardized special ethanol extract from Gynostemma pentaphyllum (GP-EX) as a management of chronic migraine.
Methods
This is a two-arm, parallel-group, randomized trial comparing GP-EX 20 mg bid or placebo bid in 64 patients with chronic migraine. Eligible patients were those who meet the broader concept of chronic migraine. The main outcome measure was the decrease in visual analogue scale (VAS) of general pain including headache and anxiety scale from baseline over a 6 weeks treatment period.
Results
The VAS decreased from 4.6±2.3 before treatment to 2.8±2.6 after 6 week of GP-EX treatment (vs. placebo: from 5.4±1.9 to 3.9±2.8 p=0.017). In all questionnaires using in this study, the anxiety in group with GP-EX was decreased significantly than one in patients with placebo (STAI-S=from 47.6±10.8 (mean±SD) to 43.7±10.7 in patient with GP-EX, p=0.017 vs. from 48.3±12.9 to 45.8±10.2 in patients with placebo, p>0.05; STAI-T=from 48.8±11.5 to 43.2±11.6 in patient with GP-EX, p=0.017 vs. from 48.4±11.2 to 44.8±11.5 in patients with placebo, p>0.05; ASI =from 32.4±14.3 to 26.3±16.2 in patient with GP-EX, p=0.017 vs. from 30.2±14.2 to 25.4±13.8 in patients with placebo, p>0.05). The most frequent adverse reactions considered possibly related to treatment were mild gastrointestinal events.
Conclusions
GP-EX 20 mg bid treatment might be effective in reducing general pain and anxiety in chronic migraine patients.

한국인구집단에서 체질량지수와 편두통: Korean Headache Survey 자료 분석: Soo Hwan Yim, Byung-Kun Kim, Kwang-Soo Lee, Kyungmi Oh, Min Kyung Chu; Korean J Headache. 2012;13(1):7-12. Published online June 30, 2012

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Abstract PDF: 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.

소아 복부편두통의 임상적 특징과 편두통 이행에 관여하는 위험인자: Eun Young Kim, Ji Hyun Kim, Saet Byul Woo, Jee Hyun Lee, Ah Young Jung, Sung Koo Kim, Kon-Hee Lee; Korean J Headache. 2012;13(1):13-18. Published online June 30, 2012

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Abstract PDF: Objective: Abdominal migraine (AM) is an idiopathic recurrent disorder occurring primarily in children. There are a few studies, even though AM frequently interferes with normal activity and is recognized as migraine prodrome. We therefore analyzed the clinical characteristics of AM and its risk factors for developing migraine later.
Methods
Among 923 children visited with recurrent abdominal pain, we studied 84 fulfilled the International Classification of Headache Disorder for the diagnosis of AM from January 2006 to December 2010. Through chart review and telephone interview, we evaluated and followed up the patients. We divided the patients into two groups by whether the migraine occurred later, and then compared them to find its risk factors.
Results
The mean age of 84 AM was 7.1±3.0 years and 60 (71.4%) were girls. The duration of abdominal pain was 4.3 ±12.7 hours and their severity was all above moderate. Sites of abdominal pain were periumbilical or diffuse at 71 (84.5%). The associated symptoms were anorexia (n=35, 15.5%), nausea (n=58, 69.0%), vomiting (n=26, 31%), and minute headache (n=64, 76.2%). Twenty seven (32.1%) with AM were occurred with migraine 1.7±0.8 years later from onset of AM. Between the migraine and the non-migraine group, there were no statistically differences in age, gender, characteristics of abdominal pain, and associated symptoms. But AM patients significantly developed migraine later at their association with headache (p=0.003) or necessity of drug therapy (p=0.034).
Conclusion
A third of AM developed migraine later and its risk factors were association with headache or necessity of drug therapy.

다양한 수막염에서 뇌척수액내 아데노신탈아미노 효소의 활성도: Doo Hyuk Kwon, Dong Kuck Lee; Korean J Headache. 2012;13(1):19-22. Published online June 30, 2012

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Abstract PDF: Objective: Adenosine deaminase (ADA) is the catalysing enzyme for the deamination of adnosine to inosine. CSF ADA is thought to be released by T lymphocytes during cell mediated immune response such as tuberculous meningitis. We studied CSF ADA level in various meningitis patients.
Methods
We assayed the activity of ADA in the CSF of 162 patients with various types of meningitis from May 2008 through May 2012 at Daegu Catholic University Hospital. All patients were received CSF study involving ADA level and brain imaging. The patients were separated into tuberculous meningitis, non-tuberculous meningitis and aseptic meningitis groups.
Result
Numbers of tuberculous meningitis, non-tuberculous meningitis and aseptic meningitis patients were 17, 28 and 117. Mean values of ADA level in tuberculous meningitis, non-tuberculous meningitis and aseptic meningitis were 12.26±4.41 IU/L, 9.43±16.9 IU/L, and 3.26±2.91 IU/L. The CSF ADA was very high in 2 patients of severe non-tuberculous meningitis (61 and 77 IU/L). The cut-off values of CSF ADA level for diagnosing tuberculous meningitis was 10 IU/L. The mean ADA value in CSF was higher in tuberculous meningitis than in other meningitis. The sensitivity of the test for diagnosing tuberculous meningitis was 0.82 and specificity, 0.97. Increased CSF protein in tuberculous meningitis (175.17±61.9 mg/dL) showed in relative linearity with ADA activity in CSF (p<0.05).
Conclusions
We thought that CSF ADA level may help in early diagnosis of tuberculous meningitis. However, sometimes higher ADA level can observed in severe bacterial meningitis.

앞대뇌동맥박리와 동반된 극치감두통 1례: Jin Ok Kim, Gun Sei Oh, Soo Joo Lee, Min Sun Kim, Youngchai Ko; Korean J Headache. 2012;13(1):23-25. Published online June 30, 2012

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Abstract PDF: Orgasmic headache, defined as an explosive headache occurring during orgasm, is most frequently a primary headache disorder. However, a number of conditions such as stroke (ischemic or hemorrhagic) and reversible segmental vasoconstriction may be associated with orgasmic headache. We report a 35-year-old patient with an episode of severe orgasmic headache who were diagnosed as anterior cerebral artery dissection on CT and conventional angiography.

두통과 경부통으로 내원한 Lemierre 증후군 1례: Kang-Seok Kim, Ye Rim Kim, Dong Won Lee, Mi Ri Kang, Yoo Kyoung Kim, Joon-hyun Shin; Korean J Headache. 2012;13(1):26-29. Published online June 30, 2012

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Abstract PDF: Lemierre’s syndrome is a rare acute oropharyngeal infectious condition characterized by clinical features such as headache, neck pain, fever and chilling sense and radiologic evidence of internal jugular vein thrombosis. Although widespread use of antibiotics has led to a markedly improved the incidence and prognosis of this syndrome, Lemierre’s syndrome could be associated with significant morbidity and fatality. Moreover, no specific clinical features in the early stage of Lemierre’s syndrome may result in the delay of diagnosis. We report a 53-year-old male of Lemierre’s syndrome with sustained vascular headache and neck pain.

후종격동 종양 절제 후 발생한 두개내압 저하로 인한 두통: Eun Hye Jang, Mi-Jung Kim, Sun Ju Chung; Korean J Headache. 2012;13(1):30-33. Published online June 30, 2012

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Abstract PDF: Intracranial hypotension due to cerebrospinal fluid (CSF) leakage is characterized by orthostatic headache that worsens in upright position and is relieved by recumbent position. Spinal surgeries may cause iatrogenic CSF leaks and presents clinical manifestations of intracranial hypotension. We report a patient who presented orthostatic headache due to intracranial hypotension after posterior mediastinal mass excision.

두통과 체중감소를 동반한 소아 다카야스동맥염 1례: Saet Byul Woo, Ji Hyun Kim, Eun Young Kim, Ah Young Jung, Jung Won Lee, Sung Koo Kim, Kon-Hee Lee; Korean J Headache. 2012;13(1):34-37. Published online June 30, 2012

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Abstract PDF: Takayasu’s arteritis (TA) is a chronic large-vessel vasculitis of unknown etiology primarily affecting young women of Asian descent. The early manifestations are often followed by vascular bruits, hemiparesis, retinopathy due to localized ischemia of involved vessels. Depending on the degree, various neurologic manifestations also can be observed. Amongst them, headache is the most common neurologic presentation in TA patients. Since the clinical manifestations in pediatric patients are less specific than in adults, diagnosis of TA is challenging without typical localized ischemic symptoms. In this report, we discuss a case of an 8-year-old girl diagnosed as TA, who initially presented no typical vascular symptom and only with vague symptoms: headache, weight loss, febrile sense.

접형동염에 의한 이차적인 경막외 농양 1례: Ji-Hyung Lee, Su Jeong You; Korean J Headache. 2012;13(1):38-40. Published online June 30, 2012

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Abstract PDF: Sphenoid sinusitis is a rare condition which is seldom complicated by severe cranial complications that may cause of severe headache. We describe a 12-year-old girl presenting headache. She was found to have sphenoid sinusitis accompanied by an epidural abscess in the left middle cranial fossa and the left masticator space. Her symptoms and signs improved after prompt treatment with antibiotics and endoscopic drainage. Sphenoid sinusitis with intracranial complication should be included in the differential diagnosis of patients with only severe headache.

무거운 가방을 메고 싸이클링은 한 후 발생한 자발성 기립성 저혈압의 예: Jung-Won Shin, Hyung-Min Kwon; Korean J Headache. 2012;13(1):41-42. Published online June 30, 2012

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Abstract PDF: Spontaneous intracranial hypotension (SIH) is important cause of daily persistent headache and trivial traumatic events precede the onset of symptoms in about one third of patients. One patient presented with spinal cerebral fluid leakage manifesting as disabling headache after cycling with backpack. We discuss that wearing heavy backpack for a long time can affect musculoskeletal and soft tissue injury in the spine, then this event can result in SIH.

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