PURPOSE: Recurrent headaches are common among Korean students, causing absences from school or learning impediments. However, most school nurses are unable to provide appropriate diagnosis and treatment as they lack accurate information about the clinical aspects or treatment of headaches. The aim of this study was to investigate school nurses's clinical knowledge, assessment, and management of headache and educational needs in headache management. METHODS: This was a cross-sectional study targeting 250 school nurses who participated in the training lecture hosted by and were working at elementary, middle, and high schools. Surveys with insufficient data were excluded. RESULTS: Participants were 237 school nurses; 122 elementary school nurses, 62 middle school nurses, and 53 high school nurses, with an average age of 42.4±8.8 years. In all, 58.2% of the school nurses responded that they had received headache education, 68.8% responded that they knew the classifications of a headache, and 38.4% responded that they knew a headache assessment method. Only, 29% had a protocol for headache treatment. The educational needs (0-7 points) of school nurses to manage students with headaches were 5.8 for headache knowledge education, 5.5 for acute pharmacotherapy, 5.0 for preventive pharmacotherapy, 6.0 for lifestyle modification, and 6.0 for complementary remedy. CONCLUSION: School nurses had high educational needs for headache management but, they had insufficient knowledge of headaches and had not a protocol for the headache management in most cases. It suggests that headache knowledge education should be performed and the standardized headache management guideline should be developed to improve the performance of school nurses.
Classification ; Cross-Sectional Studies ; Diagnosis ; Disease Management ; Drug Therapy ; Education ; Headache* ; Humans ; Learning ; Life Style ; Methods ; School Nursing

PURPOSE: Recurrent headaches are common among Korean students, causing absences from school or learning impediments. However, most school nurses are unable to provide appropriate diagnosis and treatment as they lack accurate information about the clinical aspects or treatment of headaches. The aim of this study was to investigate school nurses's clinical knowledge, assessment, and management of headache and educational needs in headache management. METHODS: This was a cross-sectional study targeting 250 school nurses who participated in the training lecture hosted by and were working at elementary, middle, and high schools. Surveys with insufficient data were excluded. RESULTS: Participants were 237 school nurses; 122 elementary school nurses, 62 middle school nurses, and 53 high school nurses, with an average age of 42.4±8.8 years. In all, 58.2% of the school nurses responded that they had received headache education, 68.8% responded that they knew the classifications of a headache, and 38.4% responded that they knew a headache assessment method. Only, 29% had a protocol for headache treatment. The educational needs (0-7 points) of school nurses to manage students with headaches were 5.8 for headache knowledge education, 5.5 for acute pharmacotherapy, 5.0 for preventive pharmacotherapy, 6.0 for lifestyle modification, and 6.0 for complementary remedy. CONCLUSION: School nurses had high educational needs for headache management but, they had insufficient knowledge of headaches and had not a protocol for the headache management in most cases. It suggests that headache knowledge education should be performed and the standardized headache management guideline should be developed to improve the performance of school nurses.
Classification ; Cross-Sectional Studies ; Diagnosis ; Disease Management ; Drug Therapy ; Education ; Headache* ; Humans ; Learning ; Life Style ; Methods ; School Nursing

Craniofrontonasal dysplasia(CFND), a rare congenital syndrome, is characterized by varying degrees of frontonasal dysplasia, craniosynostosis, and variable extracranial abnormalities. It was first reported by Cohen in 1979. The inheritance pattern is not straightforward. Although all modes of Mendelian inheritance have been suggested, the most plausible explanation is that this is an X-linked condition with the unusual situation of complete expression in females, and minimal to no expression in males. In our case, CFND was diagnosed in a female neonate who had unilateral coronal craniosynostosis, frontal bossing, orbital hypertelorism, broad nasal root, clefting nasal tip, corpus callosum agenesis and mild extremity abnormalities.
Agenesis of Corpus Callosum ; Craniosynostoses ; Extremities ; Female ; Humans ; Hypertelorism ; Infant, Newborn ; Inheritance Patterns ; Male ; Orbit ; Parturition* ; Wills

No abstract available.
Tissue Expansion Devices*

Reflex seizures induced by micturition are rare, and there have been few reports on ictal electroencephalogram (EEG) findings. Here, we report a 7-year-old boy with secondarily generalized partial seizures induced by micturition. The seizures occurred every time he urinated. A few seconds after micturition begun, he toppled down with hand automatism followed by a secondarily generalized tonic posture and loss of consciousness. Ictal video-EEG recording during urination was performed. An ictal EEG demonstrated a polyspike wave discharge onset from the left frontotemporal region, with rapid spread to the right frontotemporal region. He was treated with the antiepileptic drug valproate sodium, which improved seizure control. He remained seizure-free until the last followup for a period of 2 years.
Automatism ; Child ; Electroencephalography ; Follow-Up Studies ; Hand ; Humans ; Posture ; Reflex ; Seizures ; Unconsciousness ; Urination ; Valproic Acid

PURPOSE: To assess the prevalence and characteristics of headache comorbidity with epilepsy in children and adolescents in a specialty epilepsy clinic. METHODS: Two hundred twenty nine consecutive patients attending the Chosun University Hospital Pediatric Epilepsy Clinic (mean age 10.0+/-4.1 years, range 4-17, M:F ratio 1.1:1.0) were interviewed with a standardized headache questionnaire. Headache was classified according to the International Classification of Headache Disorders, 2nd Edition and epilepsy was classified according to the International League Against Epilepsy. Disability was assessed using pediatric migraine disability assessment (PedMIDAS). RESULTS: Of the 229 epilepsy patients, 86 (37.6%) had co-morbid headache. Of the headache patients, 64 (74.4%) had migraine (65.6%- migraine without aura, 20.3% - migraine with aura, 14.1% - probable migraine). The mean headache frequency was 7.2+/-8.4 per month, mean duration was 2.2+/-4.0 hours, mean severity was 5.2+/-2.2 out of 10, and mean PedMIDAS score was 13.0+/-35.4. The proportion of females was not higher in epilepsy with headache patients (48.8%) compared to epilepsy patients alone (48.0%). In the patients with migraine, 48.4% had complex partial seizures, 17.2% had simple partial seizures, and 34.4% had generalized seizures (P=0.368). A postictal association of migraine was reported in 18.8% with 17.2% reporting a preictal headache, and 7.8% reporting an ictal headache. CONCLUSION: The prevalence of headache in pediatric epilepsy is higher than that in general pediatric population, suggesting a co-morbidity of headache in epilepsy patients with migraine being the most frequent headache disorder. Altered cerebral excitability resulting in an increased occurrence of spreading depression may explain the headache comorbidity with epilepsy. Further studies are needed to assess the etiology of this co-morbidity as well as assess the frequency, duration, severity and disability response to antiepileptic drugs.
Adolescent* ; Anticonvulsants ; Child* ; Classification ; Comorbidity* ; Depression ; Epidemiology* ; Epilepsies, Partial ; Epilepsy* ; Female ; Headache Disorders ; Headache* ; Humans ; Migraine Disorders ; Migraine with Aura ; Migraine without Aura ; Prevalence ; Surveys and Questionnaires ; Seizures

Primary exercise headache (PEH) is usually precipitated by prolonged physically strenuous exercise. The headache is usually bilateral, severe, and pulsating in character in the patients with exercise headache. The pathophysiological mechanisms of PEH are still unknown. Most investigators believe it is vascular in origin, hypothesizing that venous or arterial distension secondary to physical exercise is the pain-inducing mechanism. The jump-rope could also evoke PEH due to intracranial venous congestion from retrograde jugular venous flow. Indomethacin is known to be effective for the majority of the cases. This is the first case with primary exercise headache from the jump-rope in Korean children.
Child* ; Exercise ; Headache* ; Humans ; Hyperemia ; Indomethacin ; Research Personnel

PURPOSE: Both headache and obesity are prevalent and chronic conditions among children. A well-known pathophysiology of migraine is that calcitonin gene-related peptide (CGRP) is an important postsynaptic mediator of trigemino-vascular inflammation. Plasma CGRP levels have been shown to increase in obese individuals during the headache phase of migraines. The purpose of this study was to assess the relationship between headache and plasma CGRP levels in obese children. METHODS: We prospectively studied plasma CGRP levels in 33 patients (20 overweight and obese subjects without headache, 13 overweight and obese subjects with headache) who visited Chosun University Hospital from March 2009 to September 2009. Blood samples were collected from cubital veins and plasma levels of CGRP were measured by radioimmunoassay. RESULTS: The mean age was 12.3+/-2.3 (range 6-15 years) and mean CGRP level was 19.1+/-2.5 pg/ml in the overweight and obese with headache group and 17.4+/-5.1 pg/mL in the overweight and obese without headache group. In the group CGRP levels lower than 19 pg/mL, mean headache frequency per month, mean severity, and mean disability were 17.0+/-18.4, 4.0+/-2.8 and 2.0+/-0.0, respectively. In the group with CGRP levels of 19 or greater pg/ml, levels were 11.0+/-9.8, 5.6+/-1.0, and 23.1+/-8.2, respectively. CONCLUSION: The mean CGRP level in overweight and obese children with headache was not significantly higher than in those without headache (P =0.202). Further, there was no significant correlation between CGRP level and frequency, severity of headache, and disability due to headache (P > 0.05). Further studies are needed to access the relationship of CGRP and pediatric headache in obese subjects.
Calcitonin ; Calcitonin Gene-Related Peptide ; Child ; Headache ; Humans ; Inflammation ; Migraine Disorders ; Obesity ; Overweight ; Plasma ; Prospective Studies ; Veins

The relation between headache and diabetes mellitus (DM) is interesting. The pathogenesis of headache in diabetic patients has been suggested to stem from the fact that DM reduces vascular reactivity and causes numerous changes of neurotransmitters that may be relevant in the pathogenesis of migraines; however, this mechanism remains unclear. We report a 17-year-old female patient with newly diagnosed type 2 diabetes mellitus, without any past history and symptoms of diabetes mellitus, who presented with persistent severe headache for 10 days. She did not complain of any headache following DM treatment. The author recommends that pediatricians consider and investigate diabetes mellitus in cases of progressive or persistent headache or refractory headache with headache treatment.
Adolescent ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Female ; Headache ; Humans ; Neurotransmitter Agents

The principle of surgery of the parotid gland is adequate removal of the tumor with functional and anatomical preservation of all blanches of the facial nerve. There are two main surgical approaches to superficial or total conservative parotidectomy. Anterior approach and posterior approach. Preliminary identification of the main trunk of the facial nerve is probably the most favoured techniques, but identification of the peripheral blanches of the facial nerve, with subsequent Proximal dissection to the main trunk, is long established but less popular technique. We have prospectively experienced the low incidence of facial nerve damage in series of 55 conservative parotidectomies performed using the anterior approach. The techniques employed is described with a deport of results obtained in the belief that this approach warrants greater popularity and saute technique.
Facial Nerve ; Incidence ; Parotid Gland ; Prospective Studies