두통이 있는 학생들에서 두통과 관련된 장애와 예측인자:

노영일(Young Il Rho),주정연(Jung Yeon Joo),정희정(Hee Jung Chung),이건희(Kon Hee Lee),은백린(Baik Lin Eun),은소희(So Hee Eun),남상욱(Sang Ook Nam),김원섭(Won Seop Kim),김영옥(Young Ok Kim) 대한소아신경학회 2017 대한소아신경학회지 Vol.25 No.1

목적: 두통은 학생들이 흔하게 경험하는 신경학적 증상이며, 반복적으로 두통이 있으면 학교 결석이나 학업 및 과외 활동에도 지장을 초래할 수 있다. 국내에서는 아직 이에 연구가 없는 실정이다. 본 연구는 우리나라 학생들의 두통에 의한 장애 정도를 평가하고 두통에 의한 장애 예측인자를 알아 보고자 하였다. 방법: 이 연구는 횡단적 단면 학교 기반 연구로 총 5,039명(남자 2,405, 여자 2,634명)이 참여 하였으며, 나이 범위는 6-18세 이었다. 설문지는 국제두통분류 제 2판에 따라 구성하였고 학교에서 선생님을 통해 배포하고 수집하였다. 결과: 두통이 있는 학생 1,465명 중 이 연구를 위한 질문에 온전히 답한 학생은 666명이었다. Grade 1의 장애를 보인 학생은 88.6%이였으며, 평균 PedMIDAS는 5.11±11.17 이었다. 나이가 들수록 두통에 의한 장애가 더 심해지는 경향이었으며, 16-18세에서 가장 심했다. 편두통이 있는 학생이 다른 두통이 있는 학생보다 두통에 의한 장애가 더 심했다. 두통에 의한 장애 예측인자는 심한 두통(P=0.028, 빈번한 두통(P=0.003), 방문 전 병력이 긴 두통이었다(P=0.008). 결론: 두통에 의한 장애는 나이가 들수록 더 심하였으며, 편두통이 있는 학생이 가장 심했다. 두통에 의한 장애 예측인자는 심한 두통, 빈번한 두통, 방문 전 병력이 긴 두통이었다. Purpose: Headache is a frequent neurological symptom in school aged individuals and recurrent headache has significant disabling effects among children and adolescents that manifest as school absenteeism, decreased extracurricular activities, and poor academic performance, as shown in previous studies. In Korea, there has not yet been a population-based study of headache-related disability in children and adolescents. We sought to estimate headache-related disability and investigate relevant predictors of disability due to headaches among schoolchildren in South Korea. Methods: This was a cross-sectional school-based study. We surveyed 5,039 (boys 2,405, girls 2,634) students aged 6-18 years. Among 1,465 students with headache, six hundred sixty-six schoolchildren (225 boys, 441 girls) completed all questionnaires. The questionnaires collected demographic data, in addition to headache specific questions consistent with International Classification of Headache Disorder criteria, 2nd edition. Disability was evaluated using the 6-question Pediatric Migraine Disability Assessment (PedMIDAS). Results: : Six hundred sixty six school children and adolescents (225 boys, 441 girls) among 1,465 students with headaches completed all questionnaires. The percentage of headache sufferers with grade I disability was 88.6%. The mean (±standard deviation) PedMIDAS score was 5.11±11.17. There was a trend towards more severe disability in the older age groups, particularly among the 16 to18 year-olds. Students with migraine had the highest PedMIDAS scores (6.69±10.66) whereas students reporting other types of headache had the lowest scores (3.81±7.52). The predictors of headache-related disability were intensity (P=0.028), frequent headache (P=0.003), and longer duration of symptoms prior to presentation (P=0.008). Conclusion: : A trend towards a more severe disability was observed in the older age group. Schoolchildren with migraine had the most headache-related disability. The predictors for headache-related disability were intensity, frequent headache, and longer duration of symptoms prior to presentation.

소아 두통 환자에서 간질과의 연관성에 관한 연구

박소현(So Hyeon Park),정희정(Hee Jung Chung) 대한소아신경학회 2010 대한소아신경학회지 Vol.18 No.2

Purpose : Headache, especially migraine disorders, have been thought to be pathophysiologically related to epilepsy. We sought to elucidate the differential diagnostic clues between headache and epilepsy by analyzing the clinical characteristics of patients who presented with a chief complaint of headache and who had been subsequently diagnosed with epilepsy. Methods : We studied 399 patients with headache who had been followed-up in Pediatrics Department of Ilsan Hospital from January 2005 to July 2009. Patients were divided into two groups and analyzed retrospectively. The test group included 15 patients who had been diagnosed with epilepsy. The control group included 305 patients whose symptoms had been diagnosed as primary headache. We compared the type of headache, presence of aura, subtype of aura, family history of migraine disorders, EEG findings, and response to a hyperventilation test between the two groups. Results : 305 patients had primary headache, 20 patients secondary headache, and 74 patients unclassified headache. Between the two groups, there was no statistically significant difference in mean age, sex, type of headache (P =0.23), type of aura (P =0.64), or associated family history (P =0.84). However the epilepsy group had more migraine with aura (P <0.05), more EEG abnormalities (P <0.0001), and more abnormal hyperventilation test (P <0.0001), which were all statistically significant. Conclusion : The presence of aura, probably visual aura, and EEG abnormalities or abnormal response in hyperventilation test are very useful differential diagnostic clues for epilepsy in headache patients. Therefore, we highly recommend that EEG are performed in order to rule out the possibility of epilepsy in those children who present with headache and have migraine headache with aura and abnormal result on hyperventilation test.

Case Series Report on the Effect of Hand Acupuncture - Focusing on 29 Patients with Headache -

Sun, Seung-Ho KOREAN PHARMACOPUNCTURE INSTITUTE 2011 Journal of pharmacopuncture Vol.14 No.3

Objectives : The purpose of 29 case series is to report the possibility that a hand acupuncture is effective in relieving headache. Methods : After approval from the Institutional Review Board (IRB), I analyzed 29 cases medical records of outpatients with headache, who visited ${\bigcirc}{\bigcirc}$ oriental medical hospital from December 2008 to December 2010, who have taken a hand acupuncture's treatment without other intervention, and who were diagnosed with one disease of international classification of headache disease second version (ICHD-2). The data was analyzed with Wilcoxon signed rank test to determine whether a hand acupuncture's treatment differed between before and after treatment's Visual Analogue Scale(VAS) according to types of headache and syndrome differentiation. Statistics program was used SPSS 18.0. Differences were considered significant at P<0.05. Results : The VAS of patients with headache was reduced after treatment of hand acupuncture from $6.57{\pm}2.04$ to $2.90{\pm}2.04$ for overall headache, from $6.32{\pm}2.05$ to $2.47{\pm}2.03$ for tension-type headache(P<0.001), from $7.10{\pm}2.18$ to $3.70{\pm}1.77$ for migraine(P<0.001), and from $6.00{\pm}1.41$ to $2.50{\pm}3.54$ for headache unspecified. A hand acupuncture produced a decrease in VAS of both ascendant hyperactivity of liver yang(P<0.001) and phlegm turbidity according to syndrome differentiation(P=0.002). No adverse event were encountered in any of the patients. Conclusions : It is suggested that a hand acupuncture may be effective in relieving headache, and could be applicable to first choice of acupuncture treatment for headache.

두통 초진 환자에서 신경영상검사 소견

김병수,김수경,김재문,문희수,박광열,박정욱,손종희,송태진,주민경,차명진,김병건,조수진 대한신경과학회 2018 대한신경과학회지 Vol.36 No.4

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±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.

동의보감(東醫寶鑑)에 따른 편(偏), 담궐(痰厥) 몇 기궐두통(氣厥頭痛) 환자의 임상적 고찰

김지윤,홍현우,김재연,김기탁,허태율,박동일,감철우,Kim, Ji-Yun,Hong, Hyun-Woo,Kim, Jae-Yeon,Kim, Ki-Tak,Heo, Tae-Yool,Park, Dong-Il,Gam, Chul-Woo 대한한방내과학회 2005 大韓韓方內科學會誌 Vol.26 No.4

Objective : The purpose of this study is to investigate clinical characteristics and remedial value oriental medical therapy for sufferers of severe headache. Methods : On the authority of DongEuiBoCam, patients were classified into three groups: migraine, qi-syncope headache and phlegm-headache. All patients wert treated with acupuncture therapy and herb medicines. After that inquiry was made into the extent of improvement of headache. Results : 1. In accordance with the statistics, 56 cases(50.5%) had phlegm-syncope headache, 28 cases(25.2%) had qi-syncope headache and 27 cases(24.3%) had migraine. 2. The ratio between males and females was about 1:4. Most patients were in their forties. 3. 12 cases(31.6%) with migraine had pain only on the right side of the head, 20 cases(26.3%) with phlegm-syncope and 17 cases(45.6%) with qi-syncope headache suffered from the frontal lobe headache. 4. 8 cases(29.6%) with migraine had been suffering for a week or less, 12 cases(21.4%) with phlegm-syncope headache had been suffering for over six months and under one year and 6 cases(21.4%) with qi-syncupe headache had suffered over one year and under five. 5. Overwork and stress was deemed the main cause of migraine. Phlegm-syncope headache was also attributed to stress and tense situations. Qi-syncope headache was believed to be variously caused by traffic accident, noise, blood pressure and other reasons. 6. 46 cases(30%) felt dull headache and 32 cases(20.9%) felt dizzy. The common associated symptoms of migraine and qi-syncope headache included back, neck and shoulder pain and other pains. Dizziness was an especially prevalent symptom of phlegm-syncope headache. 7. After the oriental medical therapy, 12 cases(10.8%) almost entirely recovered, 50 cases(45%) were in about half as much pain, 45 cases(40.5%) improved little and 4 cases(3.6%) felt no improvement. Conclusions : The results support a role for oriental medical therapy in treatment of headache.

만성 두통 환아의 진단적 접근에 있어 어지럼증의 임상적 의의에 대한 연구

오진원(Jin Won Oh),이효상(Hyo Sang Lee),유황재(Hwang Jae Yoo) 대한소아신경학회 2008 대한소아신경학회지 Vol.16 No.2

목 적 : 소아에서 두통은 흔히 접하는 신경학적 증상으로 만성 두통을 보인 소아에서는 다른 질환과의 감별이 필요하다. 이에 저자들은 만성 두통을 가진 소아에서 진단적 접근 시 어지럼증을 동반하는 경우 어떤 질환을 염두에 두어 어떤 방향으로 검사를 진행해야 하며, 어떤 임상적 의의가 있는지를 알아보고자 하였다. 방 법 : 두통을 주소로 원인규명을 위해 입원을 하였거나 외래를 방문하여 검사를 받았던 환아들을 대상으로 하였다. 2004년 1월부터 2006년 7월까지의 환아들을 선별하였으며, 이들 중에 혈액검사, 소변검사, 뇌영상검사, 뇌파검사 등을 통해 원인질환을 조사할 수 있었던 총 86명이 선택되었다. 이들을 어지럼증을 동반한 군(Group A)과 어지럼증을 동반하지 않은 군(Group B)으로 나누어 연령, 성별, 두통의 임상양상, 두통의 원인에 대하여 조사하였다. 결 과 : 86명의 대상 환자 중 어지럼증을 동반한 경우(Group A)가 38명, 어지럼증을 동반하지 않은 경우(Group B)가 48명이었다. 남녀 비는 Group A는 1:1.7, Group B는 1:0.85로 Group A가 여아에서 높은 빈도를 보였으며, 연령은 Group A는 10세 이상인 경우가 73.7%로 대부분을 차지하였고, Group B는 7세 이하인 경우가 56.3%로 많은 부분을 차지하여 통계학적 유의성을 보였다. 두통의 발생시기에 있어서는 Group A는 주로 오전에 발생하였고, Group B는 주로 오후에 발생하였으며, 두통의 지속기간은 90분이상인 경우가 Group A의 50.0%에 비해 Group B는 87.5%로서 통계학적 유의성을 보였다. 두통의 발생빈도는 Group A는 대부분(92.1%)에서 주 4회 이상의 빈도를 보였으나 Group B는 주 4회 이상인 경우는 58.3%로서 Group A가 유의 있게 높은 빈도를 보였다. 동반증상으로는 Group A는 오심(47.3%), 구토(25.4%), 시력장애(12.7%) 등이었고, Group B는 시력장애(45.5%), 수명(14.8%), 구토(13.6%) 등의 순이었다. 두통의 원인으로는 Group A는 편두통(31.6%), 기립성 저혈압(15.8%), 체위성 기립성 빈맥 증후군(13.2%), 양성 발작성 두위 현훈증(10.5%) 등이었으며, Group B는 부비동염(50.0%), 편두통(31.3%), 합병성 편두통(8.3%) 등이었다. 결 론 : 만성 두통을 가진 소아에서 어지럼증을 동반한 두통을 가진 여아이면서 두통의 양상이 아침과 야간에 발생하는 특징을 보일 경우 전정기관의 이상과 체위불내성에 대한 검사를 먼저 시행하여 철저한 검사가 이루어져야 하며, 특정 질환이 의심된다 하더라도 편두통의 가능성을 두고 진단적 접근을 해야 할 것으로 사료된다. Purpose : Headache is a common neurologic symptom in children but chronic headache in them must be diagnosed in different ways. The aim of this study is to determine the algorithm of diagnostic approach for children with chronic headache and know the clinical significance of dizziness in evaluating those children. Methods : We recruited children with headache at Myongji Hospital from January 2004 to July 2006. The study was based on a retrospective review of their medical records and interviews with the children and their parents. We divided them into two groups : Group A headache with dizziness, Group B headache without dizziness. Results : The medical records of 86 children and adolescents with headache were reviewed. Age for group A ranged from 10 to 15 years(73.7%) and gender ratio was 1:1.7. Age for group B ranged mostly under 7 years(56.3%) and gender ratio was 1:0.85. Headache in group A frequently occurred predominantly in the morning(37.3%). The duration of the attack was over 90 min(87.5%) in group A and over 90 min(50.0%) in group B. Associated symptoms were mainly nausea(34.2%), vomiting(18.4%), blurred vision(12.7%) in group A. Over 90% of them had headache 4 times a week and so did dizziness. The final diagnoses in cases of group A were migraine(31.6%), orthostatic hypotension(15.8%), postural orthostatic tachycardia syndrome(13.2%), and benign paroxysmal positional vertigo(10.5%). While in group B diagnoses included sinusitis(50.0%), migraine(31.3%), and complications of migraine(8.3%). Conclusion : This study revealed high percentage of headache concurred with dizziness in children. The association of headache with dizziness is complex and maybe coincidental. If chronic headache with dizziness in girls occurs mainly in the morning, it maybe related to vestibular disorder and orthostatic instability. In conclusion, dizziness and other associated symptoms or clinical features should carefully be assessed in the diagnosis of headache.

소아 편두통 진단에 대한 두통 가족력의 영향

오승미(SeungMi Oh),신선희(SeonHee Shin),이건희(SeonHee Shin) 대한소아신경학회 2006 대한소아신경학회지 Vol.14 No.1

목 적 : 소아 청소년시기에 반복성 두통에는 일차 두통인 편두통, 긴장형두통, 소아 주기성 증후군 등이 있으며, 이차두통의 원인으로는 부비동염이 중요하지만 임상에서 각 질환의 진단은 쉽지않다. 현재 2004년도 국제두통질환 분류의 진단 기준에서는 두통시간, 횟수, 특징 및 동반 증상 등을 기초로 진단하고 있으나 가족력 사항은 제외되어 있다. 그러므로 환아의 임상 양상 및 국제 두통분류에 의한 최종 진단과 환아 가족의 두통 병력을 비교함으로써 진단에 도움이 되고자 한다. 방 법: 한림대학교 의료원 강남성심병원 소아과에 두통을 주소로 내원한 15세 이하 환자 217명을 대상으로 하였다. 환아의 두통은 두통설문지, 두통일기, 방사선 검사 등으로 진단하였고, 모계 및 부계 3대의 두통에 대한 가족력을 조사하였다. 대상환아 두통의 진단은 국제두통질환 분류에 의거하였다. 결 과: 편두통 환아의 경우 어머니에서 73.3%, 외할머니 44.8%, 어머니의 형제 24.8%, 외할아버지 8.6%로 모계 전체에서는 78.1%에서 두통의 병력이 있었다. 그러나 환아의 부계 전체에서 두통 병력의 빈도는 16.2%였다. 긴장형두통으로 진단된 환아의 가족력으로는 어머니 51.4%, 외할머니 18.9%, 어머니의 형제 24.3%로 모계 전체의 56.8%의 두통 병력이 있었다. Mantel-Haenszel 검정법으로어머니의 반복적인 두통 병력이 있을 경우 자식에게 편두통 발생 위험은 긴장형두통보다 2.94배 높았다. 또한 부모에서 반복적 두통 병력이 있는 경우는 자식에게 편두통 발생 위험은 긴장형두통보다 3.22배 높았으며, 어머니와 외할머니가 반복적인 두통 병력이 있을 때에는 3.75배로 높았다. 결 론: 소아 두통의 진단에 있어 소아두통의 발생빈도와 특징 및 동반증상을 자세히 이해하는 것이 중요하며 두통의 가족력이 있을 경우는 긴장형 두통보다는 일차적으로 소아 편두통을 고려해야 한다. 본 연구를 통해 반복성 소아 두통의 진단에 가족력이 중요함을 확인할 수 있으며 특히 편두통의 진단 기준에 가족력 항목을 참조함으로써 진단에 도움이 될 수 있기를 기대할 수 있다. Purpose : Headache is a common problem in children and adolescents, and they experience severe pain and disabilities from headache. But there had not been an appropriate system for the diagnosis and the classification for headache in children and adolescents before the international classification of headache disorders(ICHD-II) was developed. But family history was not included in this classification's criteria. So we evaluated the effects of family history on the diagnosis of children with recurrent headaches. Methods : 217 patients with recurrent headaches younger than fifteen years old were selected. To diagnose the patients' headache, we utilized headache questionnaires, headache diaries, and studied the family history of headache on the patients' maternal and paternal lines. Final diagnosis was based on the ICHD-II. Results : In the migrainous patients, 78.1% had positive family history of headache on the maternal lines, and 16.2% on the paternal lines. In the patients with tension-type headache, 56.8% had positive family history of headache on the maternal lines. When the mother of a patient suffered from recurrent headaches, migraine occurred 2.94 times as frequently as tension-type headache(Mantel-Haenszel odds ratio, 2.94; P<0.01; 95% confidence interval, 1.36-6.38). And if a patient had parents with recurrent headaches, migraine occurred 3.22 times as frequently as tension-type headache(odds ratio, 3.22; P<0.005; 95% confidence interval, 1.48-7.02). Conclusion : We can consider migraine rather than tension-type headache when a patient has family history of recurrent headaches. In our study, we were able to validate that positive family history of headache was important in diagnosing the headache of children.

소아 청소년 두통에 의한 장애와 예측인자

안지예(Ji Ye Ahn),노영일(Young-il Rho) 대한소아신경학회 2015 대한소아신경학회지 Vol.23 No.3

목적: 소아청소년 두통에 의한 장애를 평가 하고, 심한 장애를 일으 킬 수 있는 예측인지를 알아보고자 하였다. 또한 예방 치료에 따른 장 애의 변화에 대하여 알아보고자 하였다. 방법: 2010년 1월부터 2014년 12월까지 두통으로 조선대학교병원 소아신경클리닉에 방문한 환자 307명의 의무기록을 후향적으로 조사 하였다. 두통에 의한 장애를 평가하기 위해 6개의 질문으로 이루어진 PedMIDAS를 사용하였으며, 장애 정도에 따라 4개의 단계로 분류하 였다. 두통 형태는 국제두통질환분류법에 따라 분류하였다(ICHD-II). 결과: 대상 환자 중 17%에서 두통에 의해 중등도 이상의 장애가 있었다. 나이가 많을수록 장애 정도가 심한 경향을 보였다. 두통 형태 중에는 편두통이 가장 높은 장애점수를 보였다. 학교, 놀이/레저 영역 보다 집 활동에서 장애를 가장 많이 느꼈다. 두통으로 인하여 심한 장 애를 예측할 수 있는 인자는 편두통인 경우, 병력기간이 긴 경우 두통 이 잦은 경우였다. 예방 치료에 따라 두통에 의한 장애 점수는 의미 있게 감소하였다. 결론: 많은 소아 청소년 두통 환자들에서 두통으로 인하여 학교, 집 생활, 놀이 및 레저 활동에 장애가 있었고, 나이가 많을수록, 다른 두통 형태인 경우보다 편두통인 경우에 장애가 심하였다. 소아 청소 년 두통 환자가 편두통인 경우와 잦은 두통이 있는 경우, 병력기간이 긴 경우에는 두통에 의한 장애를 심하게 느낄 수 있기 때문에 두통에 대한 조기 진단과 적절한 예방 치료를 함으로써, 두통에 대한 장애를 줄이고, 소아 청소년의 삶의 질을 높일 수 있을 것으로 생각된다. Purpose: To estimate headache-related disability and to identify predictor of disability in children and adolescent with headache. In addition, to assess the improvement of disability after treatment. Method: We conducted a retrospective analysis of clinical records of children and adolescents who were presented with headache at the Chosun University Hospital between January 2010 and December 2014. Headache-related disabilities were valuated using the 6-question Pediatric Migraine Disability Assessment (PedMIDAS). The headaches were classified according to the International Classification of Headaches Disorders-II (ICHD-II). Results: A total of 307 patients were identified : 117 boys and 190 girls with a mean age of 11.3 years (range 6-18 years). About 17% of patients had a grade III-IV disability. There is a trend towards more severe disabilities in older age groups, especially in the 16-18 year-olds. The migraine patients have the highest PedMIDAS scores (19.9±26.6), whereas, the other headache patients have the lowest scores (7.9±16.0). This is higher score and severe disability at home activity (3.5±7.4) than school (2.4±4.2) and play, social or leisure activity (2.9±7.7). The predictors of disability due to headache are migraine, frequent headache and longer duration of symptom before presentation. Mean PedMIDAS score is significantly improved by treatment (P=0.002). Conclusion: A considerable number of children and adolescents with headache had a moderate to severe disability. The migraine patients have the worst disability. This study demonstrated that migraine, frequent headache and longer duration of symptom before presentation are the predictors of headache-related disability and a proper preventive treatment can improve the quality of life of pediatric headache patients.

소아 반복성 두통 환자에서 우울, 불안 성향과 행동이상

송명훈(Myoung Hoon Song),오승미(Seung Mi Oh),이건희(Kon Hee Lee) 대한소아신경학회 2008 대한소아신경학회지 Vol.16 No.1

목 적 : 소아청소년기의 두통은 흔한 질병이며 이 시기의 반복성 두통 환자에서 행동장애 또는 심리적 장애가 동반되는 경우가 있으나 이에 대한 연구가 부족하다. 저자들은 반복성 두통을 주소로 내원한 환자들을 대상으로 하여 행동적, 심리적 성향에 대해 연구하였다. 방 법 : 2006년 1월부터 2007년 7월까지 본원 소아청소년과에서 입원 또는 통원 치료를 받은 9세 이상의 반복성 두통 환자 120명과 대조군으로 비두통 환자 33명을 대상으로 하였다. 대상 아동 전체에게 아동·청소년 행동평가척도, 소아우울척도, 소아특성불안척도, 소아상태불안척도를 시행하여 결과를 비교하였다. 결 과 : 본 연구 결과 소아청소년기의 반복성 두통 환자에서 대조군과 비교하여 총 문제 행동 점수, 내재화 점수, 외현화 점수와 우울, 특성 불안, 상태 불안 점수가 의미 있게 높았다. 총 문제 행동, 내재화, 외현화 점수와 우울, 특성 불안, 상태 불안 점수는 편두통과 긴장성 두통 간에 유의한 차이가 없었다. 결 론 : 소아 두통 환자를 치료하는 데 있어 두통 증상과 함께 우울, 불안 성향과 행동학적 이상에 대한 치료를 같이하여 환자들의 삶의 질을 높일 수 있을 것으로 사료된다. Purpose : Headache is a common disorder in childhood and adolescence and frequently associated with emotional or psychological problems. In this study we studied behavioral and psychological characteristics of recurrent headache patients. Methods : We evaluated 120 patients over 9 years old with headache who visited Kangnam Sacred Heart Hospital. 33 patients who didn't have headache were included in the control group. Diagnosis was confirmed according to ICHD-2 classification and KCBCL, TAIC, CDI, and SAIC were conducted in all participants. Results : Male to female ratio was 0.7:1 in the study group and 1.1:1 in the control group and the mean age was 11.5±2.1 and 12.6±2.0 years old respectively. 73.3% of patients were migraine and 26.7% were tension type headache. The mean of KCBCL total scores was 56.2 in the migraine group, 54.0 in the tension type headache group, and 38.3 in the control group and the score was higher in the headache group(P<0.001). The means of internalizing and externalizing scores were 59.8 and 54.1 in the migraine group, 57.4 and 51.3 in the tension headache group, and 40.1 and 42.4 in the control group respectively and the scores were higher in the headache group(P<0.001). The mean scores of SAIC and TAIC were 36.3 and 33.6 in the migraine group, 36.3 and 34.6 in the tension type headache group, and 25.3 and 26.9 in the control group respectively and the scores were higher in the headache group(P<0.001). The mean scores of CDI were 14.9 in the migraine group, 14.5 in the tension type headache group, and 9.1 in the control group and the scores were higher in the headache group(P=0.002). Conclusion : The patients with recurrent headache showed statistically significant higher scores in CBCL total, internalizing, and externalizing scores, SAIC, TAIC, and CDI in comparison with the control group.

Headache related to mask use of healthcare workers in COVID-19 pandemic

( Cansu Köseoğlu Toksoy ),( Hayri Demirbaş ),( Erhan Bozkurt ),( Hakan Acar ),( Ülkü Türk Börü ) 대한통증학회 2021 The Korean Journal of Pain Vol.34 No.2

Background: It has been reported that a new type of headache may develop as a result of face mask use during the COVID-19 pandemic. The aim of this study is to investigate the clinical features of face mask-related headache during the COVID-19 pandemic. Methods: This is a cross-sectional study carried out on healthcare workers at the Afyonkarahisar Health Sciences University. The number of workers at our university was established. Sample size was calculated using the G*Power program. A questionnaire consisting of questions relating to pre-existing headache, an aggravation in headache, and de-novo headache was filled out by 3 neurologists with all participants. Results: Data was collected from a total of 375 participants, after the exclusion of 5 individuals who refused to participate. Out of all participants, 26 (6.9%) used a filtering mask, 274 (73.1%) used a surgical mask, 75 (20.0%) participants used a combination of both masks. The number of participants with preexisting headache was 114 (30.4%) had pre-existing headache. Of those with pre-existing headache, 77 (67.5%) healthcare workers had reported an aggravation in their headache after mask use. De-novo headache was observed in 116 (30.9%) of participants. De-novo headache characteristics included throbbing in 17 (14.7%) participants and pressing in 99 (85.3%) participants. In addition, symptoms such as tachypnea, sleep disturbance, and fatigue were found to be significantly higher. Conclusions: This study indicates that healthcare workers develop headaches due to use of masks during the COVID-19 outbreak.