• The Korean Journal of Pain
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• v.35 no.1
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• pp.4-13
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• 2022

Changes in diagnostic criteria, for example, the various International Classification of Headache Disorders criteria, would lead to changes in the outcomes of epidemiological studies. International Classification of Headache Disorders-1 was based mainly on expert opinion, yet most of the diagnostic criteria were reliable and valid, but it did not include chronic migraine. In its second version, the classification introduced chronic migraine, but this diagnosis resembled more a high-frequency migraine rather than the actual migraine transformation process. It also introduced medication overuse headache, but it necessitated analgesic withdrawal and subsequent headache improvement to be diagnosed as such. Hence patients having medication overuse headache could only be diagnosed in retrospect, which was an awkward situation. Such restrictive criteria for chronic migraine and medication overuse headache omitted a high proportion of patients. International Classification of Headache Disorders-3 allows a diagnosis of medication overuse headache due to combination analgesics if taken for at least 10 days per month for more than three months. Hence the prevalence rate of medication overuse headache and chronic migraine can increase compared to the previous version of the headache classification. Different criteria have been used across studies to identify chronic migraine and medication overuse headache, and therefore the information acquired from previous studies using earlier criteria becomes uncertain. Hence much epidemiological research would need to be interpreted cautiously or repeated with the most updated criteria, since the subjects in studies that apply the latest criteria may be phenotypically different from those in older studies.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.2
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• pp.102-108
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• 2016

Headache disorders, one of most common disease in general population, have been developed according to many versions of international classifications. The primary headaches are those in which no consistently identified organic cause can be determined. It is divided into the following categories: (1) migraine, (2) tension-type headache, (3) cluster headache and other trigeminal autonomic cephalalgias, (4) other primary headaches. This review described a diagnosis of primary headache disorders based on International Classification of Headache Disorders (ICHD)-3 beta criteria.

• Journal of Physiology & Pathology in Korean Medicine
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• v.31 no.4
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• pp.201-212
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• 2017

This study draws pattern differentiations of headache disorders on the ground of modern clinical applications and Korean medical literature. Categorization and symptoms of headache disorders are based on International Classification of Headache Disorders 3rd edition(beta version). And clinical papers are searched in China Academic Journals(CAJ) of China National Knowledge Infrastructure(CNKI). In the aspect of eight principle pattern identification, primary headache occurs due to lots of yang qi and has more inner pattern rather than exterior pattern, heat pattern rather than cold pattern, excess pattern rather than deficiency pattern. And primary headache is related with liver in the aspect of visceral pattern identification and blood stasis, wind and phlegm are relevant mechanisms. Migraine without aura is associated with ascendant hyperactivity of liver yang, phlegm turbidity, sunken spleen qi, wind-heat, blood deficiency or yin deficiency. Migraine with aura is mainly related with wind and it's major mechanisms are ascendant hyperactivity of liver yang, liver fire, yin deficiency of liver and kidney, blood deficiency or liver depression and qi stagnation. High repetition rate of tension-type headache can be identified as heat pattern or excess pattern. And trigeminal autonomic cephalalgias can also be accepted as heat pattern or excess pattern when the occurrence frequency is high and is relevant to combined pattern with excess pattern of external contraction and deficiency pattern of internal damage based on facial symptoms by external contraction and nervous and anxious status by liver deficiency. This study can be expected to be Korean medical basis of clinical practice guidelines on headache by proposing pattern identifications corresponding to the western classifications of headache disorders.

• Journal of Acupuncture Research
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• v.36 no.4
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• pp.187-196
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• 2019

This study was performed to review clinical research studies involving acupuncture treatment for primary headache disorders to provide a basic reference for future studies. Clinical studies of primary headache disorders treated with acupuncture were retrieved from 3 Korean electronic databases (NDSL, OASIS, and RISS). The studies were classified by year of publication, type of study, type of acupuncture, outlined acupoints, methods used for filiform needles, pharmacopuncture, auricular acupuncture, and thread-embedding acupuncture. Thirty-eight trials were reviewed, of which 33 used filiform needles, 6 pharmacopuncture, 1 auricular acupuncture, and 1used thread-embedding. Most of the studies reported that acupuncture treatment was effective in treating primary headache disorders. Some studies reported statistically significant effects, but the results overall were inconsistent. Therefore, there is insufficient evidence to support the treatment of acupuncture to resolve headaches. On the basis of these results, further studies should be performed to qualitatively and quantitatively determine the efficacy of acupuncture treatment for primary headache disorders.

• Sleep Medicine and Psychophysiology
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• v.6 no.2
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• pp.102-109
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• 1999

Headaches and sleep problems are common complaints in clinical practice. The relationship of sleep and headache has been extensively studied. Brain systems involved in the regualtion of sleep may also play a role in the initiation of vascular headache. Some of the physiological alterations in sleep, particularly REM sleep, are similar to those described in vascular headache. Clinical studies have documented an association between vascular headache and sleep, and headache is a common symptom of sleep disorders. Sleep and headache are known to be interrelated in several ways. It can be summarized as follows: 1) sleep-related headaches, 2) sleep phase-related headaches, 3) length of sleep(excess, lack, and disruption) and headaches, 4) headache related to sleep associated behavior, 5) sleep disorders and headaches, 6) effects of headaches on sleep, and 7) dreams and headaches. Several mechanisms can be proposed to explain the relationship between sleep and headaches.

• Journal of the Korean neurological association
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• v.36 no.4
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• pp.294-301
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• 2018

Background: Neuroimaging can play a crucial role in discovering potential abnormalities to cause secondary headache. There has been a progress in the fields of headache diagnosis and neuroimaging in the past two decades. We sought to investigate neuroimaging findings according to headache disorders, age, sex, and imaging modalities in first-visit headache patients. Methods: We used data of consecutive first-visit headache patients from 9 university and 2 general referral hospitals. The International Classification of Headache Disorders, third edition, beta version was used in headache diagnosis. We finally enrolled 1,080 patients undertook neuroimaging in this study. Results: Among 1,080 patients (mean age: $47.7{\pm}14.3$, female: 60.8%), proportions of headache diagnosis were as follows: primary headaches, n=926 (85.7%); secondary headaches, n=110 (10.2%); and cranial neuropathies and other headaches, n=43 (4.1%). Of them, 591 patients (54.7%) received magnetic resonance imaging (MRI). Neuroimaging abnormalities were found in 232 patients (21.5%), and their proportions were higher in older age groups and male sex. Chronic cerebral ischemia was the most common finding (n=88, 8.1%), whereas 76 patients (7.0%) were found to have clinically significant abnormalities such as primary brain tumor, cancer metastasis, and headache-relevant cerebrovascular disease. Patients underwent MRI were four times more likely to have neuroimaging abnormalities than those underwent computed tomography (33.3% vs. 7.2%, p<0.001). Conclusions: In this study, the findings of neuroimaging differed according to headache disorders, age, sex, and imaging modalities. MRI can be a preferable neuroimaging modality to identify potential causes of headache.

• The Journal of Internal Korean Medicine
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• v.39 no.6
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• pp.1191-1205
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• 2018

Objectives: This study was performed to review clinical research trends in the treatment of primary headache disorders with pharmacopuncture. Methods: We searched clinical studies on primary headache disorders treated with pharmacopuncture in four electronic databases including OASIS, RISS, CNKI, and Pubmed. The selected studies were analyzed with regard to study design, subject, intervention, evaluation, and result. Results: Five randomized controlled trials, one non-randomized controlled trial, one before-and-after study, and six case series were selected. Most of the studies showed that pharmacopuncture treatment was significantly effective in treating primary headache disorders; however, the quality of the randomized controlled trials was low. Conclusions: According to this study, pharmacopuncture could be a useful treatment option for primary headache disorders. Based on these results, further studies on the effectiveness and safety of pharmacopuncture for primary headache disorders should be performed in the near future.

• Korean Journal of Psychosomatic Medicine
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• v.2 no.1
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• pp.59-68
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• 1994

A comparison was made regarding the degree of alexithymia among patients with psychosomatic disorders, anxiety disorders and depressive disorders. The author examined the degree of alexithymia in three groups : 100 psychosomatic patients(including 47 patients with tension headache), 52 outpatients with anxiety disorden, and 50 outpatients with depressive disorders. Alexithymia was assessed by Alexithymia provoked Response Questionnaires(APRQ) developed as a semi-structured interview form. No significant difference was found in the degree of alexithymia among Patients with Psychosomatic disorders, anxiety disorders, and depressive disorders. On the other hand, patients with tension headache were significantly more alexithymic than patients with anxiety disorders and depressive disorders, respectively. However, there was no significant difference in degree of alexithymia between patients with anxiety disorders and those with depressive disorders. Multiple regression analysis revealed that demographic variables such as set age, education level, and marital status did not make a significant influence on alexithymia scores. These results suggest a greater degree of alexithymia in patients with a specific group of psychosomiatic disorders such as tension headache than in patients with emotional disorders, unlike the previous report that in general, psychosomatic patients are alexithymic. Thus, it is necessary to develop special forms of interview which can induce and encourage expression of emotion as a therapeutic strategy for patients with tension headache.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.3
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• pp.43-50
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• 2020

PURPOSE: To investigate the correlation between sleep quality, neck and shoulder pain, neck and shoulder disability, headache, and smartphone addiction in adults, as well as factors affecting sleep disorders in adults. METHODS: A total of 112 adults in their 20s were recruited for participation in this study. This study measured Pearson's correlation of sleep quality, neck and shoulder pain, neck and shoulder disability, headache and smartphone addiction. Logistic regression analysis (sleep disorder, without sleep disorder adults), was performed to analyze factors affecting sleep disorders. RESULTS: Sleep quality index was positively correlated with shoulder pain and disability index(SPADI)-pain score, SPADI-global score and smartphone addiction score. There was a significant difference in SPADI-pain score between the group with sleep disorders and the group without sleep disorders. Shoulder pain and disability were identified as factors affecting sleep disorders. The group with sleep disorders showed 1.088 times more shoulder pain than the group without sleep disorders, and the group with sleep disorders showed 1.006 times higher frequency of shoulder disorders than the group without sleep disorders. CONCLUSION: The results of the present study indicate that as sleep quality worsens, shoulder pain, disability, and smartphone addiction get worse. The group with sleep disorders had significantly increased shoulder pain compared to the group without sleep disorders. We also found that shoulder pain and disability were factors affecting sleep quality. Comparison between intervention method is warranted to better understand adults with sleep disorders.