• Journal of Oral Medicine and Pain
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• 제35권2호
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• pp.123-133
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• 2010

6개월간 경희대학교 치과병원 구강내과에 내원한 환자 중 두개주변압통과 관련된 긴장성 두통으로 진단된 총 48명(남자 11명, 여자 37명)과 측두하악장애에 기인한 두통으로 진단된 총 37명(남자 4명, 여자 33명)을 대상으로 하여 특징적 통증강도, 기능 제한 점수, 만성통증척도, 우울증 정도, 비특이적 신체 증상 등급, 하악기능과 관련된 기능제한에 대한 설문지(RDC/TMD Axis II한글판)를 통한 조사 후 다음과 같은 성적을 얻었다. 1. 특징적 통증 강도는 두개주변압통과 관련된 긴장성 두통 군에서 평균 49.937, 측두하악장애에 기인한 두통 군에서 평균 55.577를 나타냈으나 통계적으로 유의미한 차이는 없었다. 2. 기능 제한 점수는 두개주변압통과 관련된 긴장성 두통 군에서 평균 1.77, 측두하악장애에 기인한 두통 군에서 평균 2.32를 나타냈으나 통계적으로 유의미한 차이는 없었다. 3. 만성통증척도는 두개주변압통과 관련된 긴장성 두통 군에서 평균 2.02, 측두하악장애에 기인한 두통 군에서 평균 2.41를 나타냈으나 통계적으로 유의미한 차이는 없었다. 4. 우울증 정도는 두개주변압통과 관련된 긴장성 두통 군에서 평균 1.150, 측두하악장애에 기인한 두통 군에서 평균 1.049를 나타냈으나 통계적으로 유의미한 차이는 없었다. 5. 통증포함 비특이적 신체 증상 등급은 두개주변압통과 관련된 긴장성 두통 군에서 평균 1.117, 측두하악장애에 기인한 두통 군에서 평균 1.095를 나타냈으나 통계적으로 유의미한 차이는 없었다. 6. 통증비포함 비특이적 신체 증상 등급은 두개주변압통과 관련된 긴장성 두통 군에서 평균 0.939, 측두하악장애에 기인한 두통 군에서 평균 0.946을 나타냈으나 통계적으로 유의미한 차이는 없었다. 7. 하악기능과 관련된 기능제한은 두개주변압통과 관련된 긴장성 두통 군에서 평균 0.377, 측두하악장애에 기인한 두통 군에서 평균 0.387을 나타냈으나 통계적으로 유의미한 차이는 없었다. 두개주변압통과 관련된 긴장성 두통군과 측두하악장애에 기인한 두통군의 비교시 집단에 따른 척도점수의 평균에는 두 집단 사이에는 통계적으로 유사함이 관찰되었다. 이는 두개주변압통과 관련된 긴장성 두통과 측두하악장애에 기인한 두통이 임상적으로 유사한 축 II (Axis II)양상을 보인다는 것을 의미하며, 긴장성 두통의 일부분은 측두하악장애와 관련이 있다고 추론된다. 향후 긴장성 두통 진단시 측두하악장애에 대한 접근이 요구된다고 하겠다.

• The Korean Journal of Pain
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• 제33권3호
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• pp.275-283
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• 2020

Background: Previous studies showed neurography and tractography of the greater occipital nerve (GON). The purpose of this study was determining diffusion tensor imaging (DTI) parameters of bilateral GONs and dorsal root ganglia (DRG) in unilateral cervicogenic headache as well as the grading value of DTI for severe headache. The correlation between DTI parameters and clinical characteristics was evaluated. Methods: The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in bilateral GONs and cervical DRG (C2 and C3) were measured. Grading values for headache severity was calculated using a receiver operating characteristics curve. The correlation was analyzed with Pearson's coefficient. Results: The FA values of the symptomatic side of GON and cervical DRG (C2 and C3) were significantly lower than that of the asymptomatic side (all the P < 0.001), while the ADC values were significantly higher (P = 0.003, P < 0.001, and P = 0.003, respectively). The FA value of 0.205 in C2 DRG was considered the grading parameter for headache severity with sensitivity of 0.743 and specificity of 0.999 (P < 0.001). A negative correlation and a positive correlation between the FA and ADC value of the GON and headache index (HI; r = -0.420, P = 0.037 and r = 0.531, P = 0.006, respectively) was found. Conclusions: DTI parameters in the symptomatic side of the C2 and C3 DRG and GON were significantly changed. The FA value of the C2 DRG can grade headache severity. DTI parameters of the GON significantly correlated with HI.

• Journal of Acupuncture Research
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• 제29권4호
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• pp.25-34
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• 2012

Objectives : This study was conducted to investigate the effects of fixed-intensity and varied-intensity electroacupuncture in pain and sensory threshold concerning parameters visual analogue scale(VAS), brief pain inventory(BPI) and quantitative sensory testing(QST), among chronic tension headache patients. Methods : Thirty patients with chronic tension headache were randomly assigned to three groups and received different kinds of electroacupuncture at $ST_{36}$ and $ST_{37}$. Group A received fixed-intensity electroacupuncture(fixed-EA), group B received varied-intensity electroacupuncture (varied-EA), and group C received only acupuncture treatment without electrical stimulation as a control group. The intervention was given three times per week, and continued in two weeks. All the experiments were conducted blindly. Results : Fixed-EA group showed a significant decrease of VAS and BPI compared to the baseline measurement, while both varied-EA and control group did not. Of the parameters of QST, subtraction of heat pain threshold(HPT) and cold pain threshold(CPT) slightly increased in all groups, but this was not significant. Conclusions : These results suggest that fixed-EA reduce pain and improve quality of life in patients with chronic tension headache and that acupuncture may regulate patient's pain sensitivity through changing sensory threshold.

• The Korean Journal of Pain
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• 제12권2호
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• pp.231-234
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• 1999

Until several years ago we didn't think seriously about cervical problems as a cause of headaches, but since the publication of articles by Bogduk et al they have gotten more attention. Cervical headaches are associated with movement abnormalities of the structures of the neck such as cervical nerve roots, discs, joints and soft tissues. Considering this, we thought that the atlanto-axial joint could be one of the causes of these headaches. Headaches originating from this joint can be recognized by the fact that the pain worsens with rotation of the head in the horizontal plane. Pain can also be referred to the frontal area or around the orbit. We did atlanto-axial joint blocks using a posterior approach on 10 patients who suffered from this type of headache. The results were promising with 9 out of 10 patients showing more than 50% improvement on the numeric rating scale. There were no serious complications observed. We concluded that the atlanto-axial joint block can be an effective procedure in treating this specific type of headache.

• The Korean Journal of Pain
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• 제25권2호
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• pp.112-115
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• 2012

Intracranial hypotension is characterized by a postural headache which is relieved in a supine position and worsened in a sitting or standing position. Although less commonly reported than postural headache, sixth nerve palsy has also been observed in intracranial hypotension. The epidural blood patch (EBP) has been performed for postdural puncture headache, but little is known about the proper timing of EBP in the treatment of sixth nerve palsy due to intracranial hypotension. This article reports a case of sixth nerve palsy due to spontaneous intracranial hypotension which was treated by EBP 10 days after the onset of palsy.

• The Korean Journal of Pain
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• 제30권3호
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• pp.176-182
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• 2017

Background: Current evidence suggests that intravenous magnesium sulfate might be effective for reducing migraine pain. In a recent pilot study, we showed that intravenous caffeine citrate could reduce the severity of migraine headache. The objective of this study is to investigate the efficacy of intravenous caffeine citrate vs. magnesium sulfate for management of acute migraine headache. Methods: We conducted a prospective quasi-experimental study from January until May 2016 in two educational medical centers of Shahid Beheshti University of Medical Sciences (Shoahadaye Tajrish Hospital and Imam Hossein Hospital), Tehran, Iran. The study included patients who were referred to the emergency department and met the migraine diagnosis criteria of the International Headache Society. Patients were allocated into 2 groups receiving either 60 mg intravenous caffeine or 2 g intravenous magnesium sulfate. The pain scores, based on the visual analog scale, were recorded on admission, as well as one and two hours after receiving the drug. A Chi-Square test and student t-test were used for analysis of baseline characteristics. A Mann-Whitney U test and Wilcoxon singed rank test were used to analyze differences in the visual analogue scale (VAS) score between and within the groups respectively. Results: In total, 70 patients (35 patients in each group) with the mean age of $33.1{\pm}11.3years$ were included (64.3% female). For the Caffeine citrate group, the median pain score decreased from 9.0 (2.0) to 5.0 (4.0) after one hour and to 3.0 (4.0) after two hours. For the magnesium sulfate group, the pain score decreased from 8.0 (2.0) to 2.0 (2.0) after one hour and to 0.0 (1.0) after two hours. Both intravenous caffeine citrate and intravenous magnesium sulfate reduced pain scores significantly but the magnesium sulfate group showed more improvement than the Caffeine citrate group after one hour (P < 0.001) and after two hours (P < 0.001). Conclusions: It is likely that both intravenous caffeine and intravenous magnesium sulfate can reduce the severity of migraine headache. Moreover, intravenous magnesium sulfate at a dose of 2 g might be superior to intravenous caffeine citrate 60 mg for the short term management of migraine headache in emergency departments.

• 동의신경정신과학회지
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• 제33권2호
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• pp.215-225
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• 2022

Objectives: The purpose of this study was to report the effect of Korean medicine (KM) treatment on a patient diagnosed with cluster headache. Methods: The patient included in this study was diagnosed with cluster headache who received KM therapy (herbal medicine, acupuncture, moxibustion, cupping, and chu-na treatment). The main symptom of the patient was pain in the left occipital region and orbital region. It was diagnosed as a pattern of liver depression and spleen deficiency by oriental medicine. During the hospitalization period, treatment effect was evaluated by NRS. HIT-6. BDI, and STAI were additionally performed to assess depression and anxiety. Results: After 24 days of treatment, the intensity of headache decreased from NRS7 to NRS3. During follow-up at two weeks, there was no pain. Normal daily activities were possible. Conclusions: Korean medical approach might be useful for pain relief and restoration of daily living ability for patients with cluster headache.

• 대한약침학회지
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• 제12권2호
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• pp.41-50
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• 2009

Although Chronic tension-type headache(CTTH) is one of the most common symptom in primary headache, there is no definite mechanisms. But muscular factors and psychological factors is supposed to be related with CTTH according to many other studies and pressure pain threshold(PPT) is used to measure muscular factors. Methods 1. We performed this study with 63 patients fulfilling the International Headache Societ criteria for chronic tension-type headache and 20 healthy control group and measured the PPT of temporal muscle and trapezius muscle. 2. We investigated the correlation between clinical characteristic and PPT. 3. Each of the CTTH groups and Control group is divided to four group again - HNP, Spondylosis, Sprain, Normal according to Cervical spine X-ray. Results 1. The PPT of temporal muscle and trapezius muscle in the CTTH is significantly lower than that of Control. 2. In CTTH group, the PPT has significant positive relation with duration of headache and continued time of headache. And the PPT has significant inverse relation with Frequency of headache and Level of headache. 3. In CTTH group, spondylosis group has the highest PPT and normal group is second. And there are significant difference between spondylosis group and the others. Conclusion : We found that PPT is strongly significant to measure muscular factor in CTTH.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권6호
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• pp.363-367
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• 2017

Headaches are one of the most common conditions associated with temporomandibular disorder (TMD). In the present paper, we evaluated the relationship between headache and TMD, determined whether headache influences the symptoms of TMD, and reported two cases of TMD accompanied by headache. Our practical experience and a review of the literature suggested that headache increases the frequency and intensity of pain parameters, thus complicating dysfunctional diseases in both diagnostic and treatment phases. Therefore, early and multidisciplinary treatment of TMD is necessary to avoid the overlap of painful events that could result in pain chronicity.

• The Korean Journal of Pain
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• 제9권1호
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• pp.251-255
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• 1996

Headache after epidural block is the most frequent result of an unintentional dural puncture. This form of headache is usually caused by cerebrospinal fluid leakage through the dural puncture site. Another proposed cause of postdural puncture headache is the unintentional injection of air into the subarachnoid space. We experienced a case of severe headache with a patient after lumbar epidural block and discovered air in the intracranial subarachnoid space(pneumocephalus) with the aid of brain computerized tomography.