MS and migraine: are they linked?


When listing common symptoms of multiple sclerosis (MS), migraine attacks are usually not included. However, some research has suggested that people with MS have a higher incidence of certain headaches, such as migraine.

While migraine is quite common, multiple sclerosis is not. On 12 percent of people in the United States suffer from migraines, while it is estimated that nearly one million people in the United States live with MS. That’s less than 1% of the US population.

Research studies have estimated that migraine affects about 31% to 35% of people with MS. This is almost three times the prevalence of migraine in the general population.

Many people with migraine do not have MS, while people with MS may or may not experience migraine attacks. What does this mean exactly? Continue reading below as we break down the similarities between MS and migraine, how they may be related, and more.

There are several similarities between MS and migraine. Let’s explore them now.

Neurological

Both MS and migraine are neurological conditions. A neurological condition is a condition that affects your nervous system. In MS and migraine, the central nervous system, made up of the brain and spinal cord, is affected.

Chronic

Both MS and migraine are chronic health problems. This means that they are persistent or long lasting. Chronic diseases often require ongoing medical care, and many of them can have a significant impact on a person’s daily life.

Attacks

Symptoms of MS and migraine can appear during attacks. Between these attacks is typically a period of remission. It is important to note that the term “attack” means something different for each condition.

In MS, an exacerbation is a time when symptoms worsen temporarily before returning to their normal level. They are also called flare-ups or flare-ups. An example of a type of MS where this is common is relapsing-remitting MS, which is 80 percent initial diagnoses of MS.

However, not all types of MS are associated with attacks. For example, primary progressive MS is characterized by symptoms of MS that continue to gradually worsen over time.

In migraine, an attack occurs when you experience acute symptoms like throbbing or throbbing headaches, sensitivity to light, and nausea. Some people with migraine may also experience a set of symptoms called aura before a migraine attack.

Triggers

MS flares and migraine attacks can both be caused by a variety of triggers. These can include both physical and environmental factors.

Some potential triggers for MS relapses are:

  • increased stress
  • infection
  • childbirth
  • Heat
  • missed doses of MS medicine

Here are some typical migraine triggers:

You may be wondering if MS can cause migraine attacks.

Overall, the majority of people with MS and migraine have been diagnosed with migraine before being diagnosed with MS. This leads researchers to believe that MS does not cause migraine.

However, a relationship does exist. A lesion of MS in the periaqueductal gray matter (PAG) – an area of ​​gray matter found in the midbrain – can cause migraines in some people.

Medicines for MS as a trigger for migraine attacks

We mentioned earlier that certain types of medications can cause migraine attacks in some people. There are a few medications used to treat MS that can exacerbate headaches, possibly causing migraine attacks in the process. These MS medications include:

Migraine may be misdiagnosed as MS. Misdiagnosis of migraine because MS can have several important health effects, such as:

  • receiving years of unnecessary MS treatment
  • experiencing psychological stress after being diagnosed with MS
  • delay in effective migraine treatment

A 2019 study looked at the prevalence of misdiagnosis of MS in two medical centers over 12 months. He found that out of 241 people attending either clinic for MS treatment, 18 percent had been misdiagnosed. Of these people, 16 percent actually suffered from a migraine.

Additionally, a 2016 study evaluated 110 people with misdiagnoses of MS. In addition to noting that migraine was the most common alternative diagnosis, the researchers also found that:

  • For 36 of these people (33%), the duration of their misdiagnosis was 10 years or more.
  • A total of 77 people (70%) received unnecessary treatment for MS, and 34 people (31%) experienced unnecessary side effects.
  • Four participants (4 percent) had participated in a clinical trial for the treatment of MS.

Why is this happening?

Generally speaking, a misdiagnosis can occur due to the results of an MRI. For example, a person with migraine may have lesions that look very similar to those associated with MS.

A 2013 study looked at people who had an MRI for a headache and had no history of demyelinating disease like MS. After evaluating MRI scans of these people, it was found that 24.4-34.5% of MRI scans met parts of McDonald’s criteria for diagnosing MS.

Additionally, a doctor may also consider the atypical symptoms of MS as part of the diagnostic process, resulting in a misdiagnosis. This includes the symptoms of migraine.

Although many people with MS can experience migraines, headaches are usually not one of the first signs of MS. Instead, symptoms to look out for include:

Treatments are usually based on what is causing the migraine. For example, if you have been prescribed fingolimod – a disease modifying therapy (DMT) for MS – and find that it triggers migraine attacks, your doctor may change the dosage or prescribe a replacement.

Medicines for migraine fall into two categories:

Here are some examples of drugs that can be used to treat or prevent migraine in people with MS:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter (OTC) pain relievers such as ibuprofen (Advil, Motrin) or naproxen (Aleve) are often the initial treatments for mild migraine attacks.
  • Triptans. Triptans can be used to treat migraine attacks and are available in many forms, such as pills, nasal sprays, injections, and soluble tablets. Here are some examples of triptans:
  • Antidepressants. Many people with MS also have depression and may be prescribed antidepressants. Antidepressants can also be used as an effective prevention of migraine attacks. Venlafaxine (Effexor) is one example.

If you have MS, you may be more likely to have migraine attacks than someone without MS. But there is currently no medical consensus regarding the relationship between MS and migraine.

It is possible that future research will find a specific relationship. However, more research is needed.

In the meantime, if you have MS and suffer from migraine attacks, talk to your doctor about possible triggers, what you can do, and treatment options to manage both.


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