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Current Treatment Options in Neurology
Published in: Current Treatment Options in Neurology 4/2018

01-04-2018 | Headache (JR Couch, Section Editor)

Headache and Its Management in Patients With Multiple Sclerosis

Authors: Farhat Husain, MD, Gabriel Pardo, MD, Meheroz Rabadi, MD

Published in: Current Treatment Options in Neurology | Issue 4/2018

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Abstract

Purpose of review

The purpose of this review was to discuss the prevalence, impact, pathophysiology, and treatment of headaches (H/As) in patients with multiple sclerosis (MS).

Recent findings

Headaches and multiple sclerosis are more common in women than in men with the ratio of female to male being 3:1. It is not entirely clear if there is a correlation or an incidental comorbidity of two neurological conditions. A review of the literature shows a variable prevalence of H/As in MS patients. Using the International Classification of Headache Disorders (ICHD) criteria, the primary type of H/As, especially migraine, is the most common type seen in patients with MS. One of the theories of the pathophysiologic mechanisms of migraine in MS patients is inflammation leading to demyelinating lesions in the pain-producing centers in the midbrain. Secondary H/As due to MS medications such as interferons are also frequently present.

Summary

H/As can be a cause for significant comorbidity in patients with MS. The treatment of H/As in patients with MS should be addressed in the same fashion as in the non-MS population, which is a combination of pharmacological and non-pharmacological methods. Preventive medicines for the H/As should be carefully selected because of their side effect profiles. Acute attacks of migraines can be treated with medications such as triptans. Patients with MS who have migraine H/As should be educated about the phenomenon of overuse H/As, keeping headache journals, avoiding stress, and monitoring sleeping habits. The presence of depression in patients with MS and migraine affects quality of life (QOL) and should also be addressed for better outcomes.
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Metadata
Title
Headache and Its Management in Patients With Multiple Sclerosis
Authors
Farhat Husain, MD
Gabriel Pardo, MD
Meheroz Rabadi, MD
Publication date
01-04-2018
Publisher
Springer US
Published in
Current Treatment Options in Neurology / Issue 4/2018
Print ISSN: 1092-8480
Electronic ISSN: 1534-3138
DOI
https://doi.org/10.1007/s11940-018-0495-4