Headache and Pain Research

Volume 5(2); December 2004

Triptan의 심혈관계 안전성: Keun-Sik Hong; Korean J Headache. 2004;5(2):115-124. Published online December 31, 2004

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Abstract PDF: Triptans are recommended as an appropriate first-line treatment for the migraine attacks with moderate to severe severity. However, their potential of coronary vasoconstriction, considered in the context of pharmacological activity, rare reports of serious cardiac events and more commonly reported chest symp- toms, have raised the concerns about cardiovascular safety. This article reviews the data obtained from experiments, clinical trials, post-marketing surveillance, and clinical studies. While all triptans have the potential to produce small constriction of coronary artery, clinically serious events rarely occur because of their craniovascular selectivity at therapeutic dose. Data accumulated more than 10 years demonstrate that triptans are safe. Triptan-associated chest symptoms are usually nonserious and usually not attributed to ischemic mechanisms. However, these data are derived from the patients without known cardiovascular disease and cannot be extended to patients with cardiovascular disease. Korean Journal of Headache 5(2):115-124, 2004

편측 위약감과 무해 자극 통증이 동반된 편두통: Yong-Jae Kim.; Korean J Headache. 2004;5(2):125-128. Published online December 31, 2004

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Abstract PDF: Background
Patients with migraine may experience symptoms of weakness. These patients often had extensive evaluations and sometimes were labeled as having a psychiatric cause for their weakness. We hypothesized that subjects with unilateral weakness most often do not have psychiatric cause and that their weakness is related to the presence of cutaneous allodynia. Methods: Patients visited to the outpatient clinic for intractable headache were entered into study. Their symptoms during their attacks of weakness were reviewed. Sensory testing was preformed by brush allodynia testing. Giveway weakness was defined as a sudden loss of resistance during strength testing. Results: Ten of 38 patients reported having had unilateral weakness and headache. Five of these patients had unilateral giveway weakness. Mean age of these subjects was 41.2 years old, and all were women. Four had unilateral headache ipsilateral to the weakness and one had bilateral headache. All of these had brush allodynia. Three had blurry vision(ipsilateral to the headache in all, none typical scintillating scotoma). All subjects with unilateral motor or sensory symptoms had typical features of migraine; most were transformed migraine. All subjects had one or more normal neuroimaging studies and most had multiple studies. Conclusions: Severe migraine headache may be associated with unilateral sensory motor symptoms. There need more clinical data to understand the nature of migraine with unilateral motor and sensory symptoms. Korean Journal of Headache 5(2):125-128, 2004

가바펜틴에 의한 신경병증 통증의 치료:시판후 조사 결과: Byung Kun Kim; Korean J Headache. 2004;5(2):129-138. Published online December 31, 2004

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Abstract PDF: Background
Neuropathic pain is initiated or caused by a primary lesion or dysfunction in the nervous system. Current treatment modalities on neuropathic pain are often ineffective. Gabapentin, an anticonvul- sant, has become the first choice in the treatment of neuropathic pain. This study evaluated tolerability and efficacy of gabapentin therapy on neuropathic pain in routine clinical practice. Method: A multicenter, prospective, noncomparative, open label clinical trial was performed. 45 neu- rologists from 40 hospitals were participated in this study. A total of 1,202 adult patients(592 males, 610 females, mean age 59.0 years) with neuropathic pain entered the trial. Efficacy of gabapentin was evalua- ted in 1,017 patients after a minimum of 6 weeks of treatment. Results: Most patients were started on a dose of 300mg/day and mean maximum dosage was 874 mg/day. The average duration of treatment was 75.4 days. A total of 86 patients experienced 103 adverse events. The most frequent adverse events were dizziness(3.1%) and drowsiness(1.7%). Among 1,017 patients, physicians' clinical global improvement was 'markedly improved' in about 21% of patients, 'moderately improved' in about 40% and 'minimally improved' in about 26%. Mean daily pain score based on an 11-point Likert scale from baseline week to the final week of treatment was significantly reduced from 6.1 to 3.2(p<0.0001). Sleep interference score was also significantly reduced from 3.3 to 1.7(p<0.0001). Conclusions: The results of this study, performed in a real situation of clinical practice, confirmed safety and effectiveness of gabapentin in the treatment of neuropathic pain. Korean Journal of Headache 5(2):129-138, 2004

소아 편두통에 동반된 이상한 나라의 앨리스 증후군 1예: Konhee Lee, Tae-Jung Sung, Seon-Hee Shin, Sung-Koo Kim, Hae-Sun Yoon; Korean J Headache. 2004;5(2):139-142. Published online December 31, 2004

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Abstract PDF: Alice in wonderland syndrome(AIWS) refers to distortions of body image, usually in the setting of migraine with aura. A 11-year-old girl was visited to our out-patient clinic because of severe headache and dizziness. She had experienced headache since 10 months ago, but since one month ago, her head- ache was more aggravated 2 to 4 times weekly. Severe bitemporal headaches were throbbing and lasted for about 5 hours, aggravated at usual physical activities. Associate symptoms were abdominal pain, dizziness. Visual auras were frequently occurred 2 to 3 times weekly, which were fortification spectra with scotomas, blurring of vision etc. Neurologic and psychologic examination, and MRI were normal. But 2 or 3 times weekly she complained bizarre perceptual distortions: micropsia, macropsia, metamor- phopsia, distorted distance of objects, polyopsia, auditory hallucination etc. We diagnosed her as AIWS with migraine in childhood and treated with intermittent naproxen and pro- phylactic amitriptyline. She was markedly improved 2 weeks later. Korean Journal of Headache 5(2):139-142, 2004

베타차단제와 가바펜틴에 반응을 보인 SUNCT 증후군: Hak-Seung Lee, Hyuk Chang, Kwang Ho Cho; Korean J Headache. 2004;5(2):143-147. Published online December 31, 2004

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Abstract PDF: Paroxysmal short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) is a rare headache syndrome that was first described in 1989. SUNCT syndrome is charac- terized by short-lasting(usually 5-250sec), unilateral moderate to severe orbital or peri-ocular pain accom- panied by ipsilateral conjunctival injection, lacrimination, and nasal obstruction or rhinorrhea. The pain is resistant to various medications, but topiramate, gabapentin, and lamotrigine were effective in some reports. We report a 62 year-old man who was diagnosed as SUNCT syndrome, whose symptoms were effecti- vely controlled by gabapentin with β-blocker. Korean Journal of Headache 5(2):143-147, 2004

10대 편두통 환자에서 발생한 모자이크양상의 일과성 흑암시: Min-Kyung Chu, Young-Hoon Yoon, Hee-Chan Choi, Kyung-Ho Yu, Woo-Kyung Kim, Hong-Ki Song, Byung-Chul Lee, Ju-Hun Lee; Korean J Headache. 2004;5(2):148-152. Published online December 31, 2004

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Abstract PDF: Transient monocular blindness(amaurosis fugax) is uncommon in young people and its mechanism is rarely demonstrated. We report a case of young patient with recurrent amaurosis fugax of mosaic pattern. A 18 year-old female migraineur experienced recurrent episodes of monocular blindness of her left eye, which clustered over 3 weeks. The episodes lasted for 3 to 10 minutes and were not associated with head- ache. She reported that visual loss began as several dark spots scattered on the visual field which enlar- ged slowly over one to three minutes and eventually coalesced, resulting complete blindness in affected eye. After a few minutes, the vision returned in a reverse pattern; patches of vision eventually enlarging to full field. Intracranial and extracranial cerebral arteries were normal on magnetic resonance angiography. After propranolol medication, the attack was no longer observed. Amaurosis fugax in young people have different patterns of visual loss from those in elderly. The mosaic pattern of transient monocular blind- ness in young people suggested a migraine variant with benign prognosis. Korean Journal of Headache 5(2):148-152, 2004

해면정맥동 이상이 선행하고 조직검사에서 확진된 톨로자헌트 증후군 1예: Seon-Young Ryu, Sang-Bong Lee, Yeong-In Kim, Kwang-Soo Lee, Jeong-wook Park, Hye-Kyung Lee; Korean J Headache. 2004;5(2):153-157. Published online December 31, 2004

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Abstract PDF: Tolosa-Hunt syndrome(THS) is a painful ophthalmoplegia caused by an idiopathic granulomatous in- flammation of the superior orbital fissure or cavernous sinus of unknown etiology. A 72-year-old woman developed right-sided ophthalmoplegia with the pupillary dilatation and ptosis, and hypesthesia in the territory of the ophthalmic division of the right trigerminal nerve in May 2003. The MRI showed enlar- gement of right cavernous sinus by an enhancing soft tissue mass extending to the sellar region. Prior to this presentation, in August 2002, MRI done at another institusion already revealed the same soft tissue mass in the right cavernous sinus. The patient underwent a transsphenoidal biopsy which revealed chronic granulomatous inflammation with necrosis. The patient was treated with steroids, followed by the resolution of the neurologic symptoms. We report this case of biopsy-proven THS in which radiologic abnormality preceded clinical presentation by at least 10 months. Korean Journal of Headache 5(2):153-157, 2004

Images of Headache - 분만 후 발생한 뇌정맥동혈전증에 의한 두통: Korean J Headache. 2004;5(2):157-158. Published online December 31, 2004

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Abstract Review: Korean J Headache. 2004;5(2):159-166. Published online December 31, 2004

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