• Title/Summary/Keyword: Headache Migraine

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Application of Transcranial Doppler Ultrasonography(TCD) for the Diagnosis of Migraine : Preliminary Results (Transcranial Doppler Ultrasonography를 이용한 편두통의 진단: 예비연구)

  • Lee, Young-Seok;Kim, Byung-Kun
    • Annals of Clinical Neurophysiology
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    • v.1 no.1
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    • pp.31-35
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    • 1999
  • Dignosis of migraine is only based on the medical history, and objective methods to aid the clinical diagnosisare absent. Although transcranial Doppler ultrasonography (TCD) abnormalities in headache-free migraineurs have been reported previously, diagnostic criteria for migraine is still lacking and this may limit the practical application of TCD for migraine. We prospectively studied several abnormal TCD indices in interictal migraineurs and their sensitivity and specificity to define the optimal diagnostic criteria. Young (20 yrs$age=29.0{\pm}6.1yrs$) were compared to 69 controls (M:F=25:44, Mean $age=31.2{\pm}5.5yrs$). Elevated MFV (> 2SD)was observed in 63% of migraineurs while n 12% of control (p<0.01). High AI (>25%) or high HI (>3.0) was present in 17% of migraineurs, while 3% and none in controls (p<0.01). Sensitivity of elevated MFV, high AI, and high HI was 63%, 17%, 17% and specificity was 88%, 97%, 100%, respectively. If all these indices were combined, sensitivity and specificity reached 69% and 86%. These preliminary results suggest pathophysiological implication of vasospasm in interictal migraineurs, and TCD may be practically applicable for migraine. Optimal diagnostic criteria and therapeutic options for patients with abnormal TCD findings remain to bo determined.

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Utilization of Preventive Therapy in Korean Migraine Patients

  • Kim, Yewon;Park, Susin;Kim, Eonjeong;Je, Nam Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.1
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    • pp.35-43
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    • 2021
  • Background: Migraine is a common neurological disorder that affects the quality of life and causes several health problems. Preventive migraine treatment can reduce migraine frequency, headache severity, and health care costs. This study aimed to estimate the utilization of migraine preventive therapy and associated factors in eligible patients. Methods: We studied 534 patients with migraine who were eligible for migraine preventive therapy using 2017 National Patient Sample (NPS) data from the Health Insurance Review and Assessment Service (HIRA). We estimated the migraine days by calculating the monthly average number of defined daily dose (DDD) of migraine-specific acute drug. Patients with a monthly average number of DDD of 4 or more were considered as subjects for preventive treatment. Chi-square test and multiple logistic regression analysis were used to determine the association between the preventive therapy and the influencing variables. Results: Less than half of the eligible patients for prophylaxis (n=234, 43.8%) were prescribed preventive therapy. Multiple logistic regression results show that migraine preventive therapy was influenced by age, the type of migraine, and some comorbidities. Patients over the age of 50 tend to receive less prophylactic treatment than under the age of 40. On the other hand, migraine patients with epilepsy or depression were more likely to receive preventive therapy. Sumatriptan was the most preferred medication for acute treatment, and propranolol was the most commonly prescribed drug for prevention. Conclusions: More than half of the patients who were candidates for migraine prophylaxis were not receiving suitable preventive treatment. Positive factors affecting the use of migraine prevention were the presence of comorbidities such as epilepsy and depression.

A Case Report of a Migraine Patient Treated with Six-Meridian Pattern Identification (六經辨證) (육경변증(六經辨證)을 이용하여 치료한 편두통 환자 치험 1례)

  • Kim, Young-kwang;Moon, Young-ho
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.1180-1190
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    • 2020
  • The purpose of this case report is to describe the effect of Korean medicine therapy on patient with migraine. We treated migraine for 2 months using a Korean medical treatment and six-meridian pattern identification, including herbal medicine (Soshiho-tang), acupuncture, cupping, chuna, and pharmacopuncture. The measurements included a numerical rating scale (NRS), migraine disability assessment (MIDAS), headache impact test-6 (HIT-6), and migraine specific quality of life questionnaire (MSQoL) to confirm the effectiveness of the herbal medicine treatment. After treatment, the patient's complaints decreased, as shown by the results of the NRS, MIDAS, HIT-6, and MSQoL. For migraines, Korean medical treatment and six-meridian pattern identification, such as herbal medicine (Soshiho-tang), has beneficial effects for the control of migraine and improvement in the quality of life.

A clinical study of migraines without aura in children : based on revised international headache society criteria (소아 편두통에 대한 임상적 고찰 : 개정된 편두통 진단기준에 근거하여)

  • Seo, Bo Gil;Yoo, Myung Hwan;Shim, Jae Won;Shim, Jung Yeon;Jung, Hye Lim;Park, Moon Soo;Kim, Deok-soo
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.71-75
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    • 2006
  • Purpose : Because migraine in children has different characteristics from that in adults, it is inappropriate to apply migraine criteria for adults to children. Recently, the International Headache Society(IHS) revised criteria regarding children's characteristics. Therefore, we reviewed the characteristics of childhood migraines without auras based on the revised criteria and compared the data with the findings of childhood migraine by the previous criteria. Methods : Among 102 children who visited the outpatient clinic of Kangbuk Samsung Hospital for the chief complaint of headache, we analyzed the clinical findings of 34 patients, who were diagnosed as migraine without aura, and probable migraine based on the revised criteria. Results : Migraines without aura were diagnosed in 27 patients(26.5 percent) and probable migraines were observed in seven patients(6.8 percent). The usual duration of headache attacks over 2 hours was observed in 12 patients(44.4 percent). On the contrary, 15 patients(55.6 percent) usually experienced headaches for one to two hours. According to the location of headaches, there were temporal areas in 14 cases, frontal areas in nine cases, occipital areas in two cases and diffuse areas in two cases. The striking point in probable migraines is that the length of headache was below one hour in five patients. Nine patients were diagnosed as migraine without aura, when the first edition criteria was applied to same patients. Conclusion : We found that the prevalence of migraine without aura increased by the revision of IHS criteria. We hope that migraines in children will be diagnosed correctly by the new IHS criteria.

The clinical manifestation of migraine and correlation study with autonomic bioelectric response (편두통 환자의 임상 양상 및 생체전기 자율반응과의 상관성 고찰)

  • Lee, Hyun-jong;Jung, In-tae;Kim, Su-young;Lee, Doo-ik;Kim, Keon-sik;Lee, Jae-dong;Lee, Yun-ho;Choi, Do-young
    • Journal of Acupuncture Research
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    • v.21 no.3
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    • pp.215-229
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    • 2004
  • Objective : We had a clinical report in headache but didn't in migraine. We have planned this study in order to get the basic data of migraine in oriental medicine. Methods : The patient of 36 in migraine checked sex, age, onset, family history, severity of pain, influences of life, induced cause, clinical pain characteristics, associated symptom, treatment style, and prescription, frequency, using period of analgesics by a questionnaire and differentiated syndromes in migraine and evaluated autonomic bioelectric response recorder(ABR-2000). Results : There are 23.4% in prevalence rate of migraine. The ratio of sex is M:F=1:17. The age of an attack is the highest in thirties. The patient are the most in forties. The mean duration of illness is $12.0{\pm}9.9$ years. 83.4% had a family history. 61.1% had a moderate grade in severity of pain. 77.8% selected fatigue in induced cause of migraine. 69.4% had tingling sense, nausea and vomiting in the associated symptoms. 91.7% used analgesics for treatment and 51.5% of them used analgesics voluntarily. 61.9% of them take analgesics less than once in a week. 33.6% had the phlegm syncope headache in differentiation of syndrome. In ABR-2000 results, item of graph showed low tendency mostly. Conclusions : We expected that this report of clinical progress, differentiation of syndromes and ABR-2000 results in migraine would be used basic data by oriental medicine to treat migraine.

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A Clinical Study on the Case of Ophthalmoplegic Migraine Treated with Electroacupuncture (전침을 활용한 안검하수와 안구운동마비를 동반한 편두통환자의 치험 1례)

  • Lyu, Yun-Sun;No, Dong-Jin;Park, Jang-Ho;Lee, Go-Eun;Park, In-Sook;Kang, Hyoung-Won;Lyu, Yeoung-Su
    • Journal of Oriental Neuropsychiatry
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    • v.22 no.4
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    • pp.135-142
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    • 2011
  • Objectives : The purpose of this case was to investigate the effectiveness of electroacupuncture for ophthamoplegic migraine. Methods : We provided electroacupuncture therapy and prescribed oriental medicine, Joganiknoe-tang daily. We measured patient's pain by VAS(Visual Analogue Scale) and eye movement with a ruler every five days. Results & Conclusions : Any patient who has a headache with paresis of the extraocular muscle should be considered for ophthalmoplegic migraine. To diagnose ophthalmoplegic migraine, family history, past medical history, associated symptoms and signs, neurologic examinations and neuroimaging tests are needed. The symptoms of patient improved gradually within 26days from the first day of admission, and we can see her complete recovery.

Pediatric headache: a narrative review

  • Kim, Saeyoon
    • Journal of Yeungnam Medical Science
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    • v.39 no.4
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    • pp.278-284
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    • 2022
  • Headache is one of the most common neurological disorders in children and adults and can cause significant distress and disability in children and their families. The spectrum of pediatric headaches is broad, and the underlying etiology is variable. The symptoms and phenotypes of headaches in children may differ slightly from those in adults. It is important to have a good understanding of headaches in children and to distinguish between primary and secondary headaches through appropriate history assessment and neurological examination. Accurate diagnosis and appropriate drug selection are helpful for effective treatment. This article reviews headaches in children and adolescents, focusing on approaches for diagnosis and management.

Two Cases of Repetitive Episodic Tension-type Headache Patients who were Constitutionally Typed as Soyangin and Taeeumin (반복 발작성 긴장성 두통을 호소하는 소양인(少陽人) 태음인(太陰人) 치험 2례)

  • Park, Byung-Joo;Shin, Hyun-Sang;Kang, Mi-Jeong;Lee, Ji-Won;Jang, Hyun-Su;Lee, Jun-Hee;Lee, Eui-Ju;Koh, Byeong-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.22 no.2
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    • pp.123-134
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    • 2010
  • 1. Objectives: This study reports two cases of repetitive episodic tension-type headache patients who were each constitutionally typed as the Taeeum type and the Soyang type and respectively treated with Yanggyeoksanhwa-tang and Galgeunhaegi-tang. 2. Methods: The patients' subjective and objective symptoms were observed daily, and the VAS scores for the main symptoms were recorded daily throughout hospitalization period. When deemed necessary, other assessment tools were engaged (Migraine-Specific Quality of Life questionnaire, Migraine Disablity Assessment questionnaire, Headache Impact Test-6, etc.). 3. Results: The Soyang Type patient's headache improved by the end of hospitalization, with a dramatic drop in the VAS score from VAS 10 to VAS 2. The Taeeum Type patient's headache also showed improvement, with an equally dramatic decrease in the VAS score from VAS 10 to VAS 2. 4. Conclusion: Although the two patients were experiencing the same symptoms of repetitive episodic tension-type headache, they were each given different medicinal interventions in accordance to their respective constitutional types. This series of cases is notable in that the two widely different medications (Yanggyeoksanhwa-tang and Galgeunhaegi-tang) were applied to specifically conforming pathologies (the Sogal symptomatology and the Ganyeol symptomatology, respectively) to produce equally dramatic improvements.

Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders

  • Lopes, Sergio Lucio Pereira De Castro;Costa, Andre Luiz Ferreira;Gamba, Thiago De Oliveira;Flores, Isadora Luana;Cruz, Adriana Dibo;Min, Li Li
    • Imaging Science in Dentistry
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    • v.45 no.1
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    • pp.1-5
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    • 2015
  • Purpose: Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Materials and Methods: Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Results: Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. Conclusion: In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

Effect of HWANGRYUNHAEDOKTANG herd-acupuncture on functional headache (황연해독탕약침(黃連解毒湯藥針)의 기능성두통(機能性頭痛) 치료(治療) 효과(效果)에 대한 임상적(臨床的) 고찰(考察))

  • Choi, Eun-Gyu;Gu, Byung-Su
    • Journal of Oriental Neuropsychiatry
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    • v.11 no.1
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    • pp.75-81
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    • 2000
  • A clinical analysis was carried out for 37 patients who was treated for functional headache with HWANGRYUNHAEDOKTANG(黃連解毒湯) herb-acupuncture in Seoul Red-Cross Oriental Hospital. The results were as follows; 1. The effect of HWANGRYUNHAEDOKTANG(黃連解毒湯) herb-acupuncture for functional headache was turned out to be better effective the young and middle age than the old. 2. Man was better effective than woman 3. There were effective at tention headache and migraine. 4. There were effective within 6 monthes from onset. 5. There were availability in according with increasing treatment. Through the clinical consequences of therapy mentioned above, we came to confirm regular therapeutic effects for functional headache and hereafter, it is considered that a clinical comparative study on oriental cure and herb-acupuncture therapy for headache has to be more progressed than now.

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