Prevalence of Primary Headaches in People with Multiple Sclerosis

Abstract

The aim was to investigate the lifetime prevalence of headache and primary headache (diagnoses according to International Headache Society criteria) in multiple sclerosis (MS). The relationships between headache and clinical features of MS and MS therapy were also investigated. We studied 137 patients with clinically definite MS; 88 reported headache, 21 of whom developed headache after the initiation of interferon. The prevalence of all headaches in the remaining 116 patients was 57.7%. Migraine was found in 25.0%, tension-type headache in 31.9%, and cluster headache in one patient. A significant correlation (P = 0.007, Fisher's exact test) between migraine and relapsing-remitting MS was found. Primary headaches are common in MS patients. Further studies are needed to clarify the mechanisms underlying this association, particularly the association between migraine and relapsing-remitting MS, and the role of interferon in the development of new headache.

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

“…D' Amico, et al reported an overall headache prevalence of 57.7% among MS patients which included tension-type headache (31.9%), migraine (25.0%), unclassified headache (8.6%) and cluster headache (0.8%) [11]. In the present study, the prevalence of headache was 68%, which was higher than average prevalence figures reported in other studies.…”

“…EDSS scores were not significantly correlated with gender (p>0.05). Previous studies reported a mean EDSS score of 2.5-3.4 in headache-positive MS patients [11].…”

Headache in Multiple Sclerosis

“…12 In addition, several studies have shown migraines to be more common in patients with relapsing-remitting MS, and tension-type headaches to occur more frequently in the secondary progressive form. 2 However, the implications of tension-type headaches in MS are questionable. Current epidemiological studies have not provided convincing evidence that tension-type headaches are more frequent in MS patients compared with the general population, although large-scale investigations of this headache subtype are lacking.…”

“…However, several other studies have shown a highly variable trend. [2][3][4][5][6][7] We did not collect data regarding current medications, such as beta-interferon therapy or specific headache management drugs, which may influence the course of headache presentation. In order to reduce questionnaire length and encourage participation, headache subtype and stage of MS were not included in the survey.…”

“…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.…”