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Headache in Multiple Sclerosis

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Abstract

Pain, including headache, is a frequent complaint of individuals with multiple sclerosis (MS). Prevalence of headache in patients with MS was reported to be higher than 50%, but it is uncertain if this is different than what is seen in the general population. Nonetheless, it is possible that MS and headaches are comorbid. Case reports illustrated that isolated MS lesions (eg, in “strategic” regions like the midbrain) may cause severe headaches often resembling migraine. Furthermore, the role of MS disease-modifying agents needs to be taken into consideration. Mode of action and side effect profiles differ, and treatment per se may sometimes trigger headache in patients with MS. Thorough evaluation of headache in patients with MS is crucial to optimize patient management to help improve quality of life.

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References

Papers of particular interest, published recently, have been highlighted as:•Of importance ••Of major importance

  1. Archibald CJ, McGrath PJ, Ritvo PG, et al.: Pain prevalence, severity and impact in a clinic sample of multiple sclerosis patients. Pain 1994, 58:89–93.

    Article  CAS  PubMed  Google Scholar 

  2. Clifford DB, Trotter JL: Pain in multiple sclerosis. Arch Neurol 1984, 41:1270–1272.

    CAS  PubMed  Google Scholar 

  3. Moulin DE, Foley KM, Ebers GC: Pain syndromes in multiple sclerosis. Neurology 1988, 38:1830–1834.

    CAS  PubMed  Google Scholar 

  4. Stenager E, Knudsen L, Jensen K: Acute and chronic pain syndromes in multiple sclerosis. Acta Neurol Scand 1991, 84:197–200.

    Article  CAS  PubMed  Google Scholar 

  5. •• Stovner LJ, Hagen K, Jensen R, et al.: The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 2007, 27:193–210. This article is an excellent overview of global burden of headache that also shows regional differences.

    Article  PubMed  Google Scholar 

  6. Freedman MS, Gray TA: Vascular headache: a presenting symptom of multiple sclerosis. Can J Neurol Sci 1989, 16:63–66.

    CAS  PubMed  Google Scholar 

  7. Rolak LA, Brown S: Headaches and multiple sclerosis: a clinical study and review of the literature. J Neurol 1990, 237:300–302.

    Article  CAS  PubMed  Google Scholar 

  8. D’Amico D, La Mantia L, Rigamonti A, et al.: Prevalence of primary headaches in people with multiple sclerosis. Cephalalgia 2004, 11:980–984.

    Article  Google Scholar 

  9. Haas DC, Kent PF, Friedman DI: Headache caused by a single lesion of multiple sclerosis in the periaqueductal gray area. Headache 1993, 33:452–455.

    Article  CAS  PubMed  Google Scholar 

  10. Fragoso YD, Brooks JB: Two cases of lesions in brainstem in multiple sclerosis and refractory migraine. Headache 2007, 47:852–854.

    Article  PubMed  Google Scholar 

  11. Galer BS, Lipton RB, Weinstein S, et al.: Apoplectic headache and oculomotor nerve palsy: an unusual presentation of multiple sclerosis. Neurology 1990, 40:1465–1466.

    CAS  PubMed  Google Scholar 

  12. Barkhof F, Filippi M, Miller DH, et al.: Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis. Brain 1997, 120:2059–2069.

    Article  PubMed  Google Scholar 

  13. Cooney BS, Grossman RI, Farber RE, et al.: Frequency of magnetic resonance imaging abnormalities in patients with migraine. Headache 1996, 36:616–621.

    Article  CAS  PubMed  Google Scholar 

  14. Jacome DE, Leborgne J: MRI studies in basilar artery migraine. Headache 1990, 30:88–90.

    Article  CAS  PubMed  Google Scholar 

  15. Kruit MC, Launer LJ, Ferrari MD, van Buchem MA: Infarcts in the posterior circulation territory in migraine. The population-based MRI CAMERA study. Brain 2005, 128:2068–2077.

    Article  PubMed  Google Scholar 

  16. Kruit MC, Launer LJ, Ferrari MD, van Buchem MA: Brain stem and cerebellar hyperintense lesions in migraine. Stroke 2006, 37:1109–1112.

    Article  PubMed  Google Scholar 

  17. Knight YE, Goadsby PJ. The periaqueductal gray matter modulates trigeminovascular input: a role in migraine? Neuroscience 2001, 106:793–800.

    Article  CAS  PubMed  Google Scholar 

  18. Gee JR, Chang J, Dublin AB, Vijayan N: The association of brainstem lesions with migraine-like headache: an imaging study of multiple sclerosis. Headache 2005, 45:670–677.

    Article  PubMed  Google Scholar 

  19. Watkins SM, Espir M: Migraine and multiple sclerosis. J Neurol Neurosurg Psychiatr 1969, 32:35–37.

    Article  CAS  PubMed  Google Scholar 

  20. •• Putzki N, Pfriem A, Limmroth V, et al.: Prevalence of migraine, tension-type headache and trigeminal neuralgia in multiple sclerosis. Eur J Neurol 2009, 16:262–267. This article covers a population-based case-control study according to new International Headache Society diagnostic criteria, one of the largest epidemiological studies on prevalence of headache syndromes in MS.

    Article  CAS  PubMed  Google Scholar 

  21. Göbel H, Petersen-Braun M, Soyka D: The epidemiology of headache in Germany: a nationwide survey of a representative sample on the basis of the headache classification of the International Headache Society. Cephalalgia 1994, 14:97–106.

    Article  PubMed  Google Scholar 

  22. Lampl C, Buzath A, Baumhackl U, Klingler D: One-year prevalence of migraine in Austria: a nation-wide survey. Cephalalgia 2003, 23:280–286.

    Article  CAS  PubMed  Google Scholar 

  23. • Lipton RB, Bigal ME, Diamond M, et al.: Migraine prevalence, disease burden, and the need for preventive therapy. Neurology 2007, 68:343–349. This article is recommended for better understanding of the need for treatment of migraine that also gives insight on consequences of migraine for the social security systems.

    Article  CAS  PubMed  Google Scholar 

  24. Lantéri-Minet M, Valade D, Géraud G, et al.: Migraine and probable migraine: results of FRAMIG 3, a French nationwide survey carried out according to the 2004 IHS classification. Cephalalgia 2005, 25:1146–1158.

    Article  PubMed  Google Scholar 

  25. Stewart WF, Lipton RB, Celentano DD, Reed ML: Prevalence of migraine headache in the United States. Relation to age, income, race, and other sociodemographic factors. JAMA 1992, 267:64–69.

    Article  CAS  PubMed  Google Scholar 

  26. Zivadinov R, Willheim K, Sepic-Grahovac D, et al.: Migraine and tension-type headache in Croatia: a population-based survey of precipitating factors. Cephalalgia 2003, 23:336–343.

    Article  CAS  PubMed  Google Scholar 

  27. Schwartz BS, Stewart WF, Simon D, Lipton RB: Epidemiology of tension-type headache. JAMA 1998, 279:381–383.

    Article  CAS  PubMed  Google Scholar 

  28. Rieckmann P, Toyka KV: Escalating immunotherapy of multiple sclerosis. Austrian-German-Swiss Multiple Sclerosis Therapy Consensus Group [MSTCG]. Eur Neurol 1999, 42:121–127.

    Article  CAS  PubMed  Google Scholar 

  29. Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. I. Clinical results of a multicenter, randomized, double-blind, placebo-controlled trial. The IFNB Multiple Sclerosis Study Group. Neurology 1993, 43:655–661.

    Google Scholar 

  30. Jacobs LD, Cookfair DL, Rudick RA, et al.: Intramuscular interferon beta-1a for disease progression in relapsing multiple sclerosis. The Multiple Sclerosis Collaborative Research Group (MSCRG). Ann Neurol 1996, 39:285–294. (Published erratum appears in Ann Neurol 1996, 40:480.)

    Article  CAS  PubMed  Google Scholar 

  31. La Mantia, D’Amico D, Rigamonti A, et al.: Interferon treatment may trigger primary headaches in multiple sclerosis patients. Mult Scler 2006, 12:476–480.

    Article  Google Scholar 

  32. Pöllmann W, Erasmus LP, Feneberg W, et al.: Interferon beta but not glatiramer acetate therapy aggravates headaches in MS. Neurology 2002, 59:636–639.

    PubMed  Google Scholar 

  33. Vacca G, Marano E, Brescia Morra V, et al.: Multiple sclerosis and headache co-morbidity. A case-control study. Neurol Sci 2007, 28:133–135.

    Article  CAS  PubMed  Google Scholar 

  34. Pöllmann W, Erasmus LP, Feneberg W, Straube A: The effect of glatiramer acetate treatment on pre-existing headaches in patients with MS. Neurology 2006, 66:275–277.

    Article  PubMed  Google Scholar 

  35. Reess J, Haas J, Gabriel K, et al.: Both paracetamol and ibuprofen are equally effective in managing flu-like symptoms in relapsing-remitting multiple sclerosis patients during interferon beta-1a (AVONEX) therapy. Mult Scler 2002, 8:15–18.

    CAS  PubMed  Google Scholar 

  36. Río J, Nox C, Bonaventure I, et al.: Corticosteroids, ibuprofen, and acetaminophen for IFNbeta-1a flu symptoms in MS: a randomized trial. Neurology 2004, 63:525–528.

    PubMed  Google Scholar 

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Disclosures

Dr. Norman Putzki has received research funding, compensation, travel grants, and honoraria from Allergan, Almirall, Bayer Schering Pharma, Biogen Idec, GlaxoSmithKline, Merck Serono, Ipsen, Novartis, Sanofi-Aventis, Teva Neuroscience, and Wyeth. Dr. Zaza Katsarava has received research funding and honoraria from Bayer, and has consulted and served on the advisory board for Allergan.

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Authors and Affiliations

  1. Department of Neurology, University of Duisburg-Essen, Hufelandstrasse 55, Essen, 45122, Germany

    Norman Putzki

  2. Department of Neurology, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland

    Norman Putzki

  3. Department of Neurology, University Hospital Essen, Essen, Germany

    Zaza Katsarava

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  1. Norman Putzki
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  2. Zaza Katsarava
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Correspondence to Norman Putzki.

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Putzki, N., Katsarava, Z. Headache in Multiple Sclerosis. Curr Pain Headache Rep 14, 316–320 (2010). https://doi.org/10.1007/s11916-010-0126-6

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  • DOI: https://doi.org/10.1007/s11916-010-0126-6

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