A Case of Refractory Headache with Antiphospholipid Antibody Syndrome Improved by High-Intensity Warfarin Medication

Antiphospholipid antibody syndrome (APS) is a coagulation disorder associated with antiphospholipid antibodies. Headache is common in APS patients and often unresponsive to analgesics. We report a case of refractory headache in a patient with APS, who was improved by high-intensity warfarin treatment. The mechanisms of the headache in patients with APS were presumed to be hypercoagulability of microcirculation and thrombotic occlusion of the capillaries, which were associated with antiphospholipid antibodies. Therefore, high-intensity warfarin could be considered as one of the treatments for refractory headache in patients with APS.

The Reliability and Validity of the Korean Versions of the International Restless Legs Scale and the Restless Legs Syndrome Quality of Life Questionnaire

BACKGROUND: The International Restless Legs Scale (IRLS) and the Restless Legs Syndrome Quality of Life questionnaire (RLSQoL) are valid and reliable tools for assessing RLS severity and the impact of RLS on daily life in Western countries. The purpose of this study was to validate the Korean versions of these questionnaires in Korean RLS patients. METHODS: We developed the Korean versions of the IRLS and the RLSQoL. In total, 250 Korean primary RLS patients were included in this study. These questionnaires were used for the initial interview and a subsequent retest approximately 1 month later. The findings were compared with those obtained using the Clinical Global Impression, Short Form 36 Health Survey, and other instruments. The percentage agreement and Cronbach's alpha were calculated for each question, and the validity coefficients were estimated from these statistics. RESULTS: The scores for the Korean versions of the IRLS (range: 0-40) and the RLSQoL (range 0-100) proved reliably consistent (Cronbach's alpha=0.96 and 0.92, respectively) and had good test-retest reliability (intraclass correlation coefficient=0.61-0.85 and 0.61-0.89, respectively). The Korean version of the RLSQoL could be used to distinguish between groups with none, mild, moderate, severe, and very severe symptoms (F=66.10, P<0.0001). The two questionnaires proved to have high reliability and validity coefficients. CONCLUSIONS: The Korean versions of the IRLS and the RLSQoL are valid and reliable tools for assessing RLS severity and the impact of RLS on the daily life of Korean RLS patients.