Headache in Multiple Sclerosis From a Different Perspective: A Prospective Study

Year 2018, , 9 - 13, 10.03.2018

Gökhan Özer , Ufuk Ergün , Levent Ertuğrul İnan

https://doi.org/10.5799/jcei.413052

Abstract

Objective:
It is known
that patients with multiple sclerosis have a high incidence of headache.
Although there is increasing evidence to suggest that periaqueductal gray
matter (PAG) plays a role in the pathophysiology of migraine headache, it is
not known whether the type of headache may be a predictor of a MS relapse.

Patients
and Methods: The
study enrolled 100 patients (68 females, 32 males) with clinically confirmed MS
diagnosis established by McDonald diagnostic criteria. The type and duration of
MS, MRI localization of lesions and cognitive status were recorded for all
patients. Patients were questioned whether they experience headache during MS
attacks.

Results:
Sixty-eight
percent of the patients had headache and 32% of the patients were free of
headache. Of the patients with headache, 16% had tension –type headache (TTH),
14% had migraine, 11% had primary stabbing headache (PSH), 8% had TTH+
migraine, 6% had PSH+ migraine, 6% had medication overuse headache , 2% had
medication overuse headache + migraine, 2% had paroxysmal hemicrania, 1% had
cervicogenic headache, 1% had chronic TTH, and 1% had unclassified headache.
There was a statistically significant relationship between the presence of
headache and MS relapse (p<0.001). We found a statistically significant
relationship between the type of headache and the localization of plaques in
all MS patients in a statistical analysis using chi-square test, (p<0.001).

Conclusion:
Headache may be
the only symptom of a flare-up in MS patients. The relationship between
stabbing headache and MS relapses merits further investigation. 

Keywords

Multiple sclerosis, relapse, stabbing headache

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