Diagnosis – results at the first visit… “Precise and fast treatment with the latest equipment”

《Headache is one of the common pains experienced by more than 90% of Koreans. But usually, there are many cases where you will find a pharmacy that is closer than a hospital and relieve the pain then with painkillers. Unbearable or frequent headaches can be a sign that something is wrong with your body. It is better to go to the hospital and get a proper examination.

Chronic migraine is a symptom where abnormalities in the blood vessels of the brain are caused by sudden excitation of the cranial nerves. Persistent pain for more than 15 days a month or more than 180 days a year for months or years. If you have severe migraines, you may overreact to sound or light, or have difficulties in everyday life, such as vomiting, diarrhoea, loss of appetite or depression.

Headache treatment varies slightly depending on the cause. Lee Tae-gyu, director of the Lee Tae-gyu Neurology Clinic, said, “In the past, medications were mainly prescribed for migraine treatment, but recently Botox has been recognized as one of the effective treatments for headaches.” In 2010, the US Food and Drug Administration (FDA) approved Botox as a treatment for chronic migraine, and the American Academy of Neurology recommended Botox for chronic migraine patients.

When a migraine starts, nerve peptides such as calcitonin gene-related peptide (CGRP), substance P, and neurokinin A that act on blood vessels are secreted from nerve terminals. This sensitizes the nerve endings and leaks intervascular fluid (extravascular fluid) into the peridural space distal to the meningeal membrane. At this time, the headache is relieved by blocking the substance CGRP with Botox.

According to a study conducted in 1997 by Muscular Neurology and Neuroscience, when Botox is injected into the skin muscle, the muscles around the blood vessels that go to the brain are paralyzed. At this time, the secretion of pain-related neurotransmitters is inhibited and pain-sensing pain receptors are altered, thereby relieving headache. Botox blocks nerve activity in the muscles around the head and neck, which is effective in chronic migraines and other headache disorders.

Unlike medicines that have to be taken every day, Botox can have a long-term effect of around 3 months with a single injection. A Botox titration unit is injected in a total of 31 places, including the forehead, temples, back of the head, and shoulders.

However, Botox is not effective for all headache symptoms. It is highly effective for chronic migraine with headache symptoms for more than 15 days per month and combined with medication overuse headache. Although very rare, side effects of Botox headache treatment may include pain at the injection site, bruising, drooping eyelids or raised eyebrows.

Headaches have many different causes and patterns, and treatment varies depending on the diagnosis. It is important to find a headache specialist and receive treatment because persistent headaches can develop into a chronic illness if left untreated.

The Taekyu Lee Neurology Clinic, which opened in 2002, celebrated its 20th anniversary this year. Taekyu Lee Neurology Clinic specializes in the treatment and prevention of diseases of the brain and nervous system. It was the first in Korea to operate a headache clinic and stroke screening center, drawing attention from the medical community. In terms of facilities and scale, it has the best among private neurology hospitals and clinics across the country. Around 3,000 patients visit each year. Patients range in age from older people suffering from dementia, stroke, stroke, and Parkinson’s disease to young people complaining of headaches and dizziness.

The biggest advantage of Taekyu Lee Neurology Clinic is the one-stop treatment system. It allowed patients to check most results from diagnosis to results with just one visit. This is because it has the latest medical equipment, which is rare for private clinics. Taekyu Lee Neurology Clinic has 3.0 Tesla Magnetic Resonance Imaging (MRI) equipment. 3.0 Tesla is the highest specification among MRIs currently used in medical fields, and the higher the number, the better the image quality. Higher image quality enables medical staff to make a more accurate diagnosis. The 3.0 Tesla takes about 40% less shooting time than the previous version, and the inspection hole size is more than 10cm wider. This significantly reduces the patient’s complaints of mess and noise after entering the MRI. Even claustrophobic or obese patients can have the examination in a much more comfortable environment compared to previous versions of MRI. The MRI interpretation is performed by medical staff who were professors in the imaging department, so the reliability of the diagnosis is high.

A ‘carotid artery ultrasound’ is also in place with the latest equipment installed. A carotid artery ultrasound is a test that checks the degree of narrowing of the carotid artery, which runs through the neck to the head, to check if blood is flowing well. It is used to diagnose the risk of stroke or cardiovascular disease. Director Lee Tae-gyu is in charge of this inspection. Director Lee said, “It is no exaggeration to say that a patient’s life or death is determined by whether or not a 1mm difference in stroke can be detected.” An increase in carotid artery thickness of more than 1 mm increases the risk of stroke 3.6 times in men and 5.5 times in women.

It is also possible to test for sleep disorders, which are considered one of the chronic diseases of modern people. Polysomnography is a method of monitoring sleep status while sleeping overnight in hospital in order to make a comprehensive diagnosis of various sleep disorders (such as apnoea). The staff stay by the patient’s side all night and check the condition. It is almost a 24 hour operation.

In addition, the Lee Tae-gyu Neurology Clinic has an ultrasound to measure blood flow in cerebral blood vessels, a nerve conduction test and electromyography to check muscle response through electrically stimulating nerves, a possible test to observe abnormalities in electrophysiological function, blood pressure It has almost all the tools associated with diseases of the cranial nervous system, such as a blood vessel elasticity test that measures blood pressure precisely.

3.0 Tesla Magnetic Resonance Imaging (MRI) Equipment. This is the highest specification among MRIs currently used in medical fields, and the higher the number, the better the image quality. Courtesy of Taekyu Lee Neurology Clinic

No matter how much the best and latest medical equipment is, it is useless if the ability of the person using it is not supported. Taekyu Lee Neurology Clinic has the best medical staff in all fields. Director Lee is considered the nation’s foremost authority on headache prevention and stroke prevention. After graduating from medical school and graduate school at Seoul National University, he moved to the United States after completing a neurologist course at Seoul National University Hospital. He served as a pre-clinical physician at Harvard Medical School, Massachusetts General Hospital (MGH), and the Cleveland Clinic. He published a paper as the first author in the world famous medical journal ‘The Lancet’. During his tenure as a professor at Kyunghee University, he focused on migraine-related research, including the first in Korea to conduct an epidemiological study of migraine. He received the ‘Foreign Academic Award’ of the American Academy of Neurological Sciences and the ‘Young Headache Investigator Award’. He was also listed three times in the world’s three best biographical dictionaries, ‘Marquis Who’s Who’.

In addition to Director Lee, the hospital has experts in various fields. Director Kim Gyeong-joon, who worked at Seoul National University Bundang Hospital, suffered from dizziness, Parkinson’s disease, tremors, facial tremors, and sleep disorders. Director Hyung-in Cho, who served as a full-time physician at the hospital, a full-time physician for headaches and strokes, and Asan Medical Center, a full-time physician for peripheral nerve, muscle, and spinal cord diseases. They provide the best medical care to patients and are highly respected inside and outside the hospital.

Prevention is critical in diseases of the nervous system of the brain. A stroke can lead to death, a vegetative state, or severe paralysis once suffered, and the patient’s quality of life is significantly reduced. Life for a family member caring for a patient with limited mobility is also difficult. However, there are not many university hospitals or private hospitals that focus on stroke prevention in Korea. On the other hand, Taekyu Lee Neurology Clinic has a system similar to that of tertiary medical institutions for stroke prevention.

Meanwhile, the Korean Headache Society presents the ‘Lee Tae-gyu Academic Award’ every year. This award was prepared by Director Lee to honor his contribution to the development of headache medicine in Korea. In 1999, Dr. Lee of the Korean Headache Research Society, the predecessor of the Headache Society, with Jeong Jin-sang, professor of neurology at Samsung Hospital Seoul. The Lee Tae-gyu Academic Award selects the first and second prize after reviewing papers published in the Journal of the Korean Headache Society with 10 million won annually by President Lee.

Reporter Hong Eun-sim hongeunsim@donga.com