Headaches in the Different Phases of Relapsing-Remitting Multiple Sclerosis

Ergün, Ufuk; Özer, Gökhan; Şekercan, Sine; Artan, Elif; Kudiaki, Çiğdem; Üçler, Serap; Coşkun, Özlem; İnan, Levent Ertuğrul

doi:10.1097/nrl.0b013e3181906fc9

Cited by 39 publications

(32 citation statements)

References 25 publications

(25 reference statements)

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“…13 Another study has correlated primary stabbing headaches with the relapse phase of relapsing-remitting MS, implicating stabbing pain as a potential sign of acute demyelination. 14 The pain described by the patients in our study varied based on headache frequency, history, and MS progression. Patients who had a long or frequent history of headaches were more likely to report their pain as throb-Fortunately, for some the incidence of headache may be reduced using a multidisciplinary treatment approach.…”

Section: Impact On Daily Functionmentioning

confidence: 79%

Headache in Multiple Sclerosis

Tabby¹,

Majeed²,

Youngman³

et al. 2013

International Journal of MS Care

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The aim of this study was to investigate the variables affecting headache occurrence in patients with multiple sclerosis (MS). Seventy-two MS patients with comorbid headaches completed a 28-item questionnaire. This evaluation assessed each patient's demographics, headache description and modifying factors, social history, and impact on quality of life. Our patients reported a wide spectrum of headache presentations, characteristics, and resulting disability. We discuss the patterns in our data in the context of current hypotheses regarding headache and MS causality. In our patients, migraines with aura strongly correlated with MS exacerbations, suggesting that they might be useful as a marker for flare-up onset. Patients' pain descriptions varied based on their headache frequency, history, and relationship to MS progression. Due to the severity of headache in MS patients and resulting impact on their activities of daily living, a thorough analysis of headache presentation is warranted in such patients. Int J MS Care. 2013;15:73-80.P eople with multiple sclerosis (MS) have an increased incidence of headaches, although the comorbidity of headaches and MS is poorly understood. 1 Lifetime prevalence appears to be highly variable, with reports ranging from 4% to 58%. [2][3][4][5][6][7] Despite the inconsistency of prevalence reporting, there is clinical value in the identification of headache incidence in MS patients. 2,8,9 Evidence suggests that headaches may vary based on MS form and lesion location, and MS patients with migraines have a more symptomatic clinical course of the disease. 8 In addition, screening patients with MS for headaches has treatment implications. Several medications used to treat MS have been shown to exacerbate headaches, leading to a decreased quality of life and possible treatment nonadherence. 8 Owing to the highly variable presentation of headaches in patients with MS, much remains to be elucidated about the variables affecting headache development. We analyzed a number of factors in relation to headache incidence in a sample of our patients with MS, focusing on headache history, pain description, modifying factors, social history, relation to disease progression, and impact on quality of life.

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Section: Impact On Daily Functionmentioning

confidence: 79%

Headache in Multiple Sclerosis

Tabby¹,

Majeed²,

Youngman³

et al. 2013

International Journal of MS Care

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“…Moreover, although some studies showed that RRMS could be correlated with migraines, this issue could not be confirmed with other studies (3)(4)(5)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). In another study, it was suggested that deregulation of the serotonergic system may also be involved in the pathogenesis of MS as well as migraines (13).…”

Section: Introductionmentioning

confidence: 88%

Headache in multiple sclerosis

Sorgun¹,

Yücesan²,

Genç³

2013

Turk J Med Sci

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The methanol extract of Plantago major subsp. intermedia (Gilib.) Lange afforded 4 known compounds, namely isomartynoside (1), 10-hydroxymajoroside (2), β -sitosterol (3), and ursolic acid (4). Their structures were established by spectroscopic methods. After determination of the total phenolic and flavonoid contents of the methanol extract, the antioxidant potentials of the crude extract and isolated compounds 1-4 were determined by β -carotene bleaching, DPPH free radical and ABTS cation radical scavenging, and cupric reducing antioxidant capacity methods. The methanol extract, rich in phenolic contents, indicated the same DPPH free radical scavenging activity (72% inhibition) as a standard compound, butylated hydroxytoluene, at 100 μ g/mL. Isomartynoside (1), a phenylpropanoid glycoside, showed the best inhibition of lipid peroxidation, ABTS cation radical scavenging activity, and cupric reducing antioxidant capacity among the tested samples. The anticholinesterase effects of the methanol extract and isolated compounds 1-4 were established using the Ellman method. A triterpenic acid, ursolic acid (4), exhibited moderate acetyl-(54.01 ± 0.82%) and butyryl-cholinesterase (68.74 ± 0.36%) inhibitory activity at 200 μ g/mL. Isomartynoside (1) was isolated here for the first time from a Plantago species; the antioxidant and anticholinesterase activities of P. major subsp. intermedia and compounds 1-2 were not previously determined.

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“…Initial and relapse symptoms of MS may include acute brachial pain, sore throat, hypoglossal nerve palsy, epileptic seizures, and headache. It is known that headache is very common in patients with MS [1,2,3]. However, there are few studies evaluating headache as a presenting symptom or a predictor of a MS attack [4].…”

Section: Introductionmentioning

confidence: 99%

Headache in Multiple Sclerosis From a Different Perspective: A Prospective Study

Özer¹,

Ergün²,

İnan³

2018

J Clin Exp Invest

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Objective: It is known that patients with multiple sclerosis have a high incidence of headache. Although there is increasing evidence to suggest that periaqueductal gray matter (PAG) plays a role in the pathophysiology of migraine headache, it is not known whether the type of headache may be a predictor of a MS relapse. Patients and Methods:The study enrolled 100 patients (68 females, 32 males) with clinically confirmed MS diagnosis established by McDonald diagnostic criteria. The type and duration of MS, MRI localization of lesions and cognitive status were recorded for all patients. Patients were questioned whether they experience headache during MS attacks. Results: Sixty-eight percent of the patients had headache and 32% of the patients were free of headache. Of the patients with headache, 16% had tension -type headache (TTH), 14% had migraine, 11% had primary stabbing headache (PSH), 8% had TTH+ migraine, 6% had PSH+ migraine, 6% had medication overuse headache , 2% had medication overuse headache + migraine, 2% had paroxysmal hemicrania, 1% had cervicogenic headache, 1% had chronic TTH, and 1% had unclassified headache. There was a statistically significant relationship between the presence of headache and MS relapse (p<0.001). We found a statistically significant relationship between the type of headache and the localization of plaques in all MS patients in a statistical analysis using chi-square test, (p<0.001). Conclusion: Headache may be the only symptom of a flare-up in MS patients. The relationship between stabbing headache and MS relapses merits further investigation.

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Headaches in the Different Phases of Relapsing-Remitting Multiple Sclerosis

Abstract: The high frequency of PSHs in relapse was notable, and, to the best of our knowledge, PSH was not reported in relapsing-remitting multiple sclerosis before. Further studies with larger samples are recommended.

Cited by 39 publications

References 25 publications

Headache in Multiple Sclerosis

Headache in Multiple Sclerosis

Headache in multiple sclerosis

Headache in Multiple Sclerosis From a Different Perspective: A Prospective Study

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