• Title/Summary/Keyword: Pain: headache

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Herpes Zoster Ophthalmicus Accompanying Blindness, Extraocular Motor Palsies and Contralateral Hemiplegia -A Case Report- (실명, 안구마비 및 반대측 수족마비를 동반한 Herpes Zoster Ophthalmicus -1예 보고-)

  • Kim, Dong-Jin;Goh, Joon-Seock;Min, Byung-Woo
    • The Korean Journal of Pain
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    • v.3 no.2
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    • pp.160-164
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    • 1990
  • Herpes Zoster Ophthalmicus comprises 7% of all herpes zoster infection, 50% of those involving eyeballs, and is one disease entitiy with a very grave prognosis. We have experienced a 68-year-old man who visited the emergency room complaining of severe pain in his eye and headache with loss of vision. He was seen by neurosurgeons, dermatologists and ophthalmologists, and finally sent to the pain clinic for control of pain under the diagnosis of herpes zoster ophthalmicus. In spite of zealous treatment efforts, loss of vision, pain and infectious condition did not recover; and furthermore, due to severe infection, he had his eyeball extracted 100 days after the onset of diseases. 140 days after onset, contralateral hemiplegia accompanied the disease process. We present an unusual case of herpes zoster ophthalmicus with no treatment effect.

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The clinical manifestation of tension-type headache and correlation study with autonomic bioelectric response (긴장형(緊張型) 두통(頭痛)의 임상양상(臨床樣相) 및 생체전기 자율반응과의 상관성(相關性) 고찰(考察))

  • Choung, In-tae;Lee, Sang-hoon;Choi, Do-young
    • Journal of Acupuncture Research
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    • v.21 no.2
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    • pp.183-203
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    • 2004
  • Objective : Tension-type headache is the most common headache. The objective of this study is to find the clinical manifestation of tension-type headache and correlation with autonomic bioelectric response. Methods : This observation was carried out on 60 patients with tension-type headache. We used headache questionnaire and the Autonomic Bioelectric Response recoder(ABR-2000) for this study. Results : 1. Distribution of sex & age : male : female=5 : 7, 50s&60s group (28.3%) 2. Duration of onset : over 5years(50%), over one years(83.4%) 3. Causes of illness : stress(58.3%), severe fatigue(53.5%), tension(33.3%) 4. Time of attack : irregular(56.7%), day time(16.7%) 5. Pattern of pain: heavy(31 people), stiffness of occipital region (27 people) tightening around the head(25 people) 6. Curve : 40%, 56.7%, 35.0% SL(Slope low) at peak 1, 2, 3/ SH&SI not found 7. Regulation : 16.7% RR(Regulation reverse) at peak 1, 25% RH(Regulation high) at peak 2, 15% RR(Regulation reverse) at peak 3 8. Graph : Activity-60.0%, 70.0%, 63.3% lowered reaction(L, LR, L!) at peak 1, 2, 3 Reactivity-83.3%, 95.0%, 93.3% lowered reaction at peak 1, 2, 3 Conclusion : We find tension-type headache has remarkable relativeness with autonomic bioelectric response.

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Treatment of the Headache (두통의 치료)

  • Chung, Kyung-Cheon
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.263-273
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    • 1999
  • Headache is a symptom with varied etiologies and extraordinarily frequent. Headaches can be a symptom of another diseases, such as meningitis, subarachnoid hemorrhage or brain tumor, may represent the disease entity itself as the case in migraine. The international Headache Society criteria were the first to distinguish between primary and secondary headache disorders. When evaluating a patient who presents with headache, the physician abviously needs to identify or exclude the myriad conditions that can cause secondary headache and initial diagnostic workup should be considered. If patient meets the criteria for a primary headache disorder, treatment commonly initiated without additional neurodiagnostic tests. The headache type, its associated feature, and the duration and the intensity of the pain attack all can influence the choice of acute therapy in migraine. Pharmacologically, such as NSAIDs, combination analgesics, vasoactive antimigraineous drugs, neuroleptics, antidepressants, or corticosteroids. Other approches to managing headache include a headache diary to identify triggers, biofeedback, relaxation technique and behavioral modification. Daily preventive medication should be considered by his attack frequency and intensity, and maintained for 4 to 6 months. Tension-type headaches are distinguished between episodic and chronic tension-type headache, but physician must make sure that patient is not drug-overuse or independent during symptomatic abortive therapy or preventive medication. The most difficult headache patients to treat are those with chronic daily headache. They often have physical dependency, low frustration tolerance, sleep problems, and depression. So discontinuation of overused medication is crucial. New developments in migraine therapy are broadening the scope of abortive and prophylactic treatment choices available to the physician. The enhanced ease of the use of sumatriptan and DHE will likely increase patient compliance and satisfaction.

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Current understanding of nociplastic pain

  • Yeong-Min Yoo;Kyung-Hoon Kim
    • The Korean Journal of Pain
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    • v.37 no.2
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    • pp.107-118
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    • 2024
  • Nociplastic pain by the "International Association for the Study of Pain" is defined as pain that arises from altered nociception despite no clear evidence of nociceptive or neuropathic pain. Augmented central nervous system pain and sensory processing with altered pain modulation are suggested to be the mechanism of nociplastic pain. Clinical criteria for possible nociplastic pain affecting somatic structures include chronic regional pain and evoked pain hypersensitivity including allodynia with after-sensation. In addition to possible nociplastic pain, clinical criteria for probable nociplastic pain are pain hypersensitivity in the region of pain to non-noxious stimuli and presence of comorbidity such as generalized symptoms with sleep disturbance, fatigue, or cognitive problems with hypersensitivity of special senses. Criteria for definitive nociplastic pain is not determined yet. Eight specific disorders related to central sensitization are suggested to be restless leg syndrome, chronic fatigue syndrome, fibromyalgia, temporomandibular disorder, migraine or tension headache, irritable bowel syndrome, multiple chemical sensitivities, and whiplash injury; non-specific emotional disorders related to central sensitization include anxiety or panic attack and depression. These central sensitization pain syndromes are overlapped to previous functional pain syndromes which are unlike organic pain syndromes and have emotional components. Therefore, nociplastic pain can be understood as chronic altered nociception related to central sensitization including both sensory components with nociceptive and/or neuropathic pain and emotional components. Nociplastic pain may be developed to explain unexplained chronic pain beyond tissue damage or pathology regardless of its origin from nociceptive, neuropathic, emotional, or mixed pain components.

Third Occipital Nerve Radiofrequency Neurotomy with Radiologic Open Mouth View -A case report- (방사선 구개상을 이용한 제3 후두 신경 고주파신경절개술의 시행 -증례보고-)

  • Park, Jung Ju;Jung, Mi Ae;Shim, Jae Chol
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.244-248
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    • 2006
  • Radiofrequency lesioning is a valuable tool for third occipital headache. Relative to most neural targets, a radiofrequency lesion is very small. Reliable pre-operative diagnosis of the nociceptive source is critical, as inappropriately placed lesions will not modulate pain. Knowledge of the anatomical courses of nerves and extremely precise electrode placement are required for accurate lesioning. This report describes our experience with RF lesioning in the treatment of chronic pain in two patients who suffered from third occipital headaches. In one patient, satisfactory improvement of the pain was observed after 10 months of follow up.

Simultaneous Heat-Massage Therapy for Migraine Without Aura : A Case Report (무전조성 편두통 환자에서 온열과 마사지 동시 치료의 효과: 증례보고)

  • Lee, Kwang-Jae;Yoon, Yong-Soon
    • Journal of Digital Convergence
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    • v.18 no.8
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    • pp.505-509
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    • 2020
  • A migraine was a headache disorder characterized by recurrent moderate to severe headaches. The diagnosis was based on clinical signs and symptoms. Medication, physical therapy, nerve block, and nerve stimulation could be applied for treatment. This report described a case of severe migraine without aura that lasted several weeks periodically in a 59-year-old woman. Periodic headache had lasted for more than 14 years, and although she took medicines and nerve blocks, severe pain (VAS 7) was persisted. We recommended her to use the thermo-spinal massage device (CGM MB-1401, CERAGEM Inc., Cheonan, South Korea) continuously three times a week applying in semi-automatic mode around the neck for 40 minutes. There was no change in the pain scale in the automatic mode for the first 4 weeks. Subsequently, the semi-automatic mode of the cervical area was treated for 2 weeks to relieve the pain scale, and it was confirmed that the relieved state maintained for 2 months. This case highlighted the importance in considering thermo-spinal massage devices for managing migraine without aura.

The Cross-sectional Study on Characteristics between Soyangin Heat-related Diarrhea Accompanied by Headache and Soyangin Cold-related Diarrhea Accompanied by Abdominal Pain (소양인(少陽人) 신열두통망음증(身熱頭痛亡陰證)과 신한복통망음증(身寒腹痛亡陰證)의 소증(素證) 특성에 관한 단면연구)

  • Park, Yu-Gyeong;Hong, Hae-Jin;Kim, Yun-Hee;Hwang, Min-Woo
    • Journal of Sasang Constitutional Medicine
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    • v.23 no.2
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    • pp.240-253
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    • 2011
  • 1. Objectives: The purpose of this study was to survey the Original symptoms(素證) of Soyangin's and to compare the tendency of their symptoms between Soyangin Heat-related diarrhea accompanied by headache(身熱頭痛亡陰證) and Soyangin Cold-related diarrhea accompanied by abdominal pain(身寒腹痛亡陰證). 2. Methods: We recruited 56 Soyangin subjects in the Korean Medicine clinic and researched their original symptoms. Subjects were diagnosed by the Sasang Constitutional specialists and Sasang Constitutional Medication. Subjects were two groups, confirmed to Soyangin Heat-related diarrhea accompanied by headache and Soyangin Cold-related diarrhea accompanied by abdominal pain. All subjects answered the questionnaire about their Original symptoms. We found the differences between 2 groups using the Independent-Samples T-test. Analysis was conducted using SPSS 12.0 for Korean. 3. Results and Conclusions: In Original symptoms, Tendency of overeating(p=0.01), Condition of digestion(p=0.04), Perspiration after exercise (p=0.02), Usual perspiration(p=0.00), Tiredness after perspiration(p=0.05) Cold intolerance on extremities(p=0.04), General edema(p=0.01) etc. are different between 2 groups. We found the differences of heat and cold in symptoms between two Soyangin syndromes.

Abducens Nerve Palsy after Lumbar Spinal Fusion Surgery with Inadvertent Dural Tearing

  • Cho, Dae-Chul;Jung, Eul-Soo;Chi, Yong-Chul
    • Journal of Korean Neurosurgical Society
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    • v.46 no.6
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    • pp.581-583
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    • 2009
  • Abducens nerve palsy associated with spinal surgery is extremely rare. We report an extremely rare case of abducens nerve palsy after lumbar spinal fusion surgery with inadvertent dural tearing, which resolved spontaneously and completely. A 61-year-old previous healthy man presented with chronic lower back pain of 6 weeks duration and 2 weeks history of bilateral leg pain. He was diagnosed as having isthmic spondylolisthesis at L4-5 and L5-S1, and posterior lumbar interbody fusion was conducted on L4-5 and L5-S1. During the operation, inadvertent dural tearing occurred, which was repaired with a watertight dural closure. The patient recovered uneventfully from general anesthesia and his visual analogue pain scores decreased from 9 pre-op to 3 immediately after his operation. However, on day 2 he developed headache and nausea, which were severe when he was upright, but alleviated when supine. This led us to consider the possibility of cerebrospinal fluid leakage, and thus, he was restricted to bed. After an interval of bed rest, the severe headache disappeared, but four days after surgery he experienced diplopia during right gaze, which was caused by right-side palsy of the abducens nerve. Under conservative treatment, the diplopia gradually disappeared and was completely resolved at 5 weeks post-op.

A Clinical Case Report of Taeeumin Patient Diagnosed as Fibromyalgia with Headache and Dizziness (두통, 현훈을 동반한 섬유근통 태음인 환자 치험 1례)

  • Park, Minyoung;Lee, Min-jung;Hwang, Minwoo
    • Journal of Sasang Constitutional Medicine
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    • v.32 no.4
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    • pp.129-140
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    • 2020
  • Objectives This study aimed to report significant improvement of fibromyalgia patient who was diagnosed with 'Taeeumin esophagus-cold lung-dry symptomatology' based on Sasang Constitutional Medicine. Methods The patient was treated with herbal medicine. To evaluate the results of this treatment, the patient assessed pain of Fibromyalgia by using the Numeral Rating Scale (NRS) and American College of Rheumatology Preliminary Diagnostic Criteria (ACR, 2010). Results After 64 days of treatment, the NRS of pain reduced from 6 to 2. There was no difference before and after treatment with Widespread Pain Index 7, but Symptom Severity scale score decreased from 8 to 4. Headache, dizziness, and chilling symptoms were also improved. Conclusions The patient showed a significant improvement of Fibromyalgia and accessory symptoms without any side effects, who was treated with herbal medicine.

Approaching Chronic Tension-type Headache through Sasang Constitutional Therapy: A Series of 3 Cases who were classified as the Soeum Type and Taeeum Type (만성 긴장성 두통을 호소하는 소음인(少陰人), 태음인(太陰人) 환자 3례)

  • Oh, Hye-Won;Pak, Yun-Seong;Lee, Jun-Hee;Koh, Byung-Hee;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.25 no.4
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    • pp.384-395
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    • 2013
  • Objectives We report a series of 3 chronic tension-type headache cases who were constitutionally typed as the Soeum type, Taeeum type and treated with Dangguibaekhaoguanjung-tang, Chungshimyeonja-tang or Chunghyulganggui-tang. Methods In treating 1 patient who was constitutionally typed as the Soeum type, Case 1 fell into the category of the Taeeum symptomatology, 2 patients who were constitutionally typed as the Taeeum type, Case 2 and Case 3 fell into the category of Dry-Heat symptomatology. Each patient was given Sasang medication according to protocol: Dangguibaekhaoguanjung-tang to Case 1, Chungshimyeonja-tang to Case 2, Chunghyulganggui-tang to Case 3. On admission day and approximately 2 weeks later, patients evaluated their pain and quality of life using SF-36 and HIT-6. The patients symptoms were observed daily and NRS scores were recorded daily. Results and Conclusions 2 Patients(Case1, Case2) showed improvement in their NRS scores, SF-36 scores and HIT-6 scores. 1 patient(Case3) showed improvement in NRS scores, but worse SF-36 scores and no improvement in HIT-6 scores. Treating chronic tension-type headache based on Sasang Constitutional therapy was found to be effective for managing pain. The treatment protocol suggested in this investigation should be explored and verified in future studies.