Headache and Pain Research

Volume 6(2); June 2005

목 차: Published online December 31, 2005

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한국에서 편두통 예방 치료를 위한 평가 - 편두통에 의한 장애인식 캠페인 -: Min-Kyung Chu, Sun Uck Kwon, Manho Kim, Byung-Kun Kim, Byung-Joo Kim, Yeong-In Kim, Yong-Jae Kim, Won-Joo Kim, Jae-Moon Kim, Hyun Sook Kim, Jin Kuk Do, Ki-Jong Park@; Korean J Headache. 2005;6(2):121-128. Published online December 31, 2005

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Abstract PDF: Background
Migraine is a common, disabling illness and imposes great burden on society. Migraine- related disability is often poorly communicated between patients and physicians. The prevalence, disability and medical service utilization behavior of migraine has not been evaluated sufficiently in Korea. The goal of this study is to determine the proportion of migraine among patients presented with headache in neurology clinic and to assess the level of headache related disability of patients.
Methods
This survey recruited patients who consulted to neurologists with a chief complaint of headache in 17 hospitals in Korea. Patients answered a self-administered questionnaire. The investigators independently responded another questionnaire about their patients' headache and assessed headache related disabilities after diagnostic interview. Patients suffering from headache ≥15 days per month were excluded.
Results
Among 570 patients (female 433 (76.0%), mean age 47.8±15.6) who responded adequately the questionnaire, 376 patients had migraine. Fifty-eight percent of the migraine patients were newly diagnosed as having migraine through this survey. However, 74.9% of migraineurs have taken pain-relieving drugs when headache developed; 12.3% of the migraineurs overused the medications. One hundred forty one (37.5%) migraineurs reported that they miss family, social and leisure activities because of headache. Thirty percents of migraineurs were on prophylactic medications and 14.4% of them have visited emergency room due to severe headache. The neurologists would recommend prophylactic medication in 64.3% of patients who were not on prophylaxis.
Conclusions
This study showed that migraine is the most common headache syndrome in the neu- rology clinics of Korea. Significant portion of the migraine patients have migraine-related disability. A majority of migraineurs exposed pain-relieving drugs without exact diagnosis and some of them overused them. Korean Journal of Headache 6(2):121-128, 2005

약물과용두통의 임상적 및 심리적 특성: Young-Rok Do, Jin-Kuk Do, Dong-Kuck Lee; Korean J Headache. 2005;6(2):129-136. Published online December 31, 2005

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Abstract PDF: Background
Medication-overuse headache (MOH) has been defined newly by the Classification Committee of the International Headache Society in 2003. We hypothesized that MOH has different clinical and psychologic features from any other chronic headaches and control group. The authors investigated the clinical and psychologic features of MOH sufferers diagnosed by newly defined criteria.
Methods
Using our MOH protocol and Minnesota Multiphasic Personality Inventory (MMPI), we investigated the clinical and psychologic features of 25 patients with MOH, 23 patients with chronic headaches, and 21 control subjects.
Results
The mean age of MOH patients was 50 years and female was predominantly affected. The locations, characteristics, severity, and common accompanying symptoms of MOH were various. All patients took analgesics. The mean frequency of medication was 21 days per month and duration of medication was about 8.5 years. MOH patients and chronic headache patients had higher MMPI profiles than control group in F (Infrequency), Hs (Hypochondriasis), D (Depression), Hy (Hysteria), Pd (Psychopathic Deviate), Pa (Paranoia), Pt (Psychasthenia), Sc (Schizophrenia) scales. But there was no significant difference of MMPI profiles between MOH patients and another chronic headache patients.
Conclusions
The clinical features of MOH in this study were similar to previous studies. The psychologic features of MOH were not different from those of chronic headache. MOH sufferers may be recommended individual psychologic supports as chronic headache sufferers. Korean Journal of Headache 6(2):129-136, 2005

일차두통과 근막통증증후군과의 연관성에 관한 연구: Hwa-Young Lee, Gun-Sei Oh; Korean J Headache. 2005;6(2):137-146. Published online December 31, 2005

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Abstract PDF: Background
Myofascial pain syndrome (MPS) is a regional pain syndrome characterized in part by a trigger point in a taut band of skeletal muscle and its associated referred pain. Myofascial pain due to trigger points has been reported as the most prevalent cause of painful symptoms in temporomandibular disorders. Similarly, sufficient evidence exists supporting a substantial role of myofascial trigger point pain in chronic tension-type and migraine headaches. However, the clinical features of MPS have rarely been studied in the primary headache in Korea.
Methods
This study was a retrospective, single-center chart review. Forty-two patients with primary headache and MPS, who were followed up for longer than 3 months and did not suffer from other diseases except for headache, were recruited from October 2003 to April 2004. They were divided into chronic tension-type headache (24, 57%), chronic migraine (16, 38%), and cluster headache (2, 5%). We treated a series of 42 patients with myofascial trigger point by injecting 0.5% lidocaine with multiple needle penetrations in a fanwise pattern.
Results
Trigger point injection was shown to produce complete headache elimination in 58.3% of chronic tension-type headache patients, 62.5% of chronic migraine patients, and 100% of cluster headache patients. The most common muscle that produced headache was sternocleidomastoid muscle and trapezius muscle.
Conclusion
We should understand myofascial trigger points for better treatment of the primary headache patients. The intensity of myofascial pain due to trigger points should not be underestimated as patients have rated it as equal or slightly greater than pain from other causes. Korean Journal of Headache 6(2):137-146, 2005

고혈압을 동반한 편두통 환자에서 칼슘통로 길항제 Lercanidipine의 두통빈도 감소 효과에 대한 전향적 공개 임상 연구: Soon-Tae Lee, Jeung-Eun Park, Hyun-Jung Park, Ji-Young Sim, Sun-Hi Hwang, Jong-Ha Park, Lami Kang, Manho Kim; Korean J Headache. 2005;6(2):149-153. Published online December 31, 2005

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Abstract PDF: Background
Anti-hypertensive medication is commonly used for the prophylaxis of migraine headache. Calcium channel blockers, verapamil, flunarizine, nimodipine or nifedipine have been tried as anti-migraine drug. Lercanidipine is developed as anti-hypertensive drug in Korea with high lipid solubility and longer duration of action. In this study, we attempted to test the efficacy of lercanidipine for the migraine with hypertension in an open labeled prospective study. Patients and Methods: Consecutive 107 outpatients aged 20 to 70 years (mean, 61.4±9.9), were analyzed. Diagnosis of migraine was made according to the International Headache Society criteria, and the migraineurs were assigned to treatment with lercanidipine (10 mg/day) for 12 weeks. The efficacy variables included the changes in monthly headache frequency, Headache Management Self-Efficacy Scale (HMSE), and Headache Disability Inventory (HDI).
Results
Headache frequency showed 62.5% reduction for three months with responder rate of 73%. HMSE score showed an improvement whereas HDI scores remaind unchanged.
Conclusions
Lercanidipine is an effective prophylactic agent in migraine. A double-blind placebo-controlled clinical trial is warranted. Korean Journal of Headache 6(2):149-153, 2005

상응부위를 이용하여 일차두통의 통증 부위를 확인하는 방법: Kyu Hyun Park, Tae Woo Yoo; Korean J Headache. 2005;6(2):154-160. Published online December 31, 2005

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