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What causes headaches in MS patients?

Headache is a common symptom in multiple sclerosis (MS), but not much is known about the cause of this particular symptom, which may or may not be MS related. A recent study investigated the prevalence and characteristics of headache in patients with MS to clarify the relationship between headache and MS therapies.

The study, published in the journal Multiple Sclerosis and Related Disorders, recruited 754 MS patients. All patients filled out a detailed headache questionnaire. Of the 754 patients, 515 (68%) reported having headaches. According to the International Headache Society criteria, 202 patients (39%) experienced migraine, 103 (20%) from tension-type headache and 198 (38%) with headache from the overuse of medication. Twelve patients (2%) has unclassified headache.

Three hundred and seventy seven patients (73%) were treated with interferon beta, 81 (16%) with fingolimod, 35 (7%) with teriflunomide and 22 (4%) with natalizumab, respectively.

One hundred and one (20%) reported that onset of headache occurred prior to onset of MS therapies, while 414 (80%) said headaches occurred after therapy.

A higher incidence of headache was found in patients treated with interferon beta.

Researchers found a significant association between migraine and the age of onset of MS therapies. The age of onset of headache was the earliest in patients with migraine. In migraine patients, the duration of medication use until the headache onset was the shortest when compared to other headache groups. Migraine was also more prevalent in male MS patients.

Four hundred and fifty-nine patients (89%) have sought help from a physician because of the severity and frequency of headache.

Researchers concluded the prevalence of headache among all MS patients was 68% and the results from this study indicate a possible relationship may exist between headache and MS therapies, since 80% of patients described headaches after the onset of treatments. ‘The younger start and the shorter duration of interferon beta use caused the higher incidence of headache, but this correlation was not observed in other drugs. Interestingly, medication overuse headache was far more prevalent in multiple sclerosis patients than in previously reported community populations.’

Source: MS-UK 25/09/18

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