There is a high rate of headache prevalence among patients with multiple sclerosis (MS), which may be stimulated by the therapies used to treat the disease, according to a study published in Multiple Sclerosis and Related Disorders.
Researchers analyzed the association between MS and headaches through the use of neurological history reports, structured headache interviews, and neurological examinations.
Of the 754 patients with MS included in this study, 68.3% reported headaches overall, 39% reported migraine headaches, 20% reported tension-type headaches, and 38% reported medication-overuse headaches. Women made up 61% of the headache group, and 38% women reported migraine-type headaches. Men made up 39% of the headache group, and 40% of men reported migraine-type headaches.
Patients using interferon therapy reported migraine-type headaches more frequently than medication-overuse headaches, patients using fingolimod therapy reported tension-type headaches more frequently than migraine-type headaches, and patients using teriflunomide therapy reported medication-overuse headaches more frequently than any other type of headache (P =.001, for all). Migraine-type headaches were significantly associated with the age when MS treatment started, the age headaches started, and the duration of treatment (P <.001, for all).
With regard to onset of headaches, 20% reported experiencing headaches before treatment whereas 80% reported headaches starting after treatment. On average, headaches started 1.63 years after treatment began, with medication-overuse headaches starting 1.43 years after treatment began, tension-type headaches starting 1.55 years after treatment began, and migraine-type headaches starting 1.82 years after treatment began.
Symptoms accompanying headaches, such as nausea, vomiting, and photophobia, were significantly associated with migraine-type and medication-overuse headaches (P <.001, for both). Patients experiencing medication-overuse headaches were the most likely to consult their physician about their headaches (P <.001).
Future studies need to explore the relationship and mechanism linking medication use and headaches.
With such a high frequency of headaches occurring after MS therapies began (80%), the researchers concluded, “a possible relationship may exist between headache and multiple sclerosis therapies.”
Beckmann Y, Türe S. Headache characteristics in multiple sclerosis. Mult Scler Relat Disord. 2019; 27;112-116.