Headaches are more common in people with MS. This study investigated if headaches were more likely to occur during a relapse than remission.
People with relapsing remitting MS and people without a neurological condition were questioned about if they had experienced a headache in the previous seven days and if so what were the characteristics of the headache. The people with MS were questioned during a relapse and the again three months after they had recovered.
It was found that headaches were more common during a relapse, particularly migraines. However headaches were more also more common in people with MS during remission too, when compared to the general population.
This study investigated if headaches were more common during a relapse and what type of headaches these were.
How this study was carried out
57 people with relapsing remitting MS and 57 people without a neurological condition (control group) in Iran took part and completed the study.
The people with MS were recruited to the study when they attended a hospital clinic as they were having a relapse. Members of the control group were recruited from the friends and family members that were accompanying a person with MS to the clinic.
Participants were questioned about if they experienced headaches over the previous seven days. The headaches were diagnosed and classified against the types in the International Classification of Headache Disorders.
For those that experienced headaches, information about the characteristics of their headaches were collected including:
- what type they were (migraine, tension headache or secondary headache – that is one which is the symptom of something else such as a hangover or caused by another health condition such as a sinus or ear infection)
- the severity of the headaches on a scale of 1 (lowest severity) to 10 (very severe)
- the quality of the pain (compressing, pulsating or stabbing)
- the location of the headache in the head and if this was in one location or could be felt in several locations
- the presence of other headache symptoms, in addition to pain (aversion to light, aversion to sounds, nausea, vomiting)
For the participants with MS, the researchers also collected information about their MS, current treatment with disease modifying drugs and the characteristics of the relapse they were experiencing. These participants were followed up three months after their relapse and asked the same questions about headaches.
What was found
The study found:
- Nearly half (45.6%) of the people with MS having a relapse also experienced a headache, compared to over a third (38.6%) of people when they were in remission and just under a third (27.7%) of people without a neurological condition experienced a headache.
- Headaches were more common in people with MS during a relapse.
- The most common type of headache to experience during a relapse was migraine, followed by tension headache.
- Headaches experienced during a relapse more reported to be severe and described as compressing.
- The most common headaches experienced during remission were also migraines but these were described as being less severe.
- People who had been diagnosed with MS in the last three years were more likely to experience a headache during their relapse than people who had been diagnosed for longer.
- No relationship was found between headache and the type of relapse (so site of the MS lesion).
What does it mean?
The study shows that headaches, and particularly migraines, can be more common in people with MS during a relapse. However headaches have already been found by previous research to be more common in people with MS and this is reflected in the current study by the number of people that reported headaches when they were also in remission, compared to people without neurological conditions.
However the design of this study means that although it has shown that headaches are more common during a relapse and also more likely to occur in people who have had MS for a shorter period of time it cannot explain why. The authors conclude that headache may be a warning sign that a relapse is coming and early treatment could potentially prevent a relapse developing further. However further research would be needed to investigate the link in more detail, as headaches are also highly likely to occur during remission too.
Togha M, Abbasi Khoshsirat N, Moghadasi AN, et al.
Headache in relapse and remission phases of multiple sclerosis: a case-control study.
Iran J Neurol. 2016 Jan 5;15(1):1-8.
Read the full text of this paper
More about headaches
Two previous studies covered in research update have shown that headaches and migraines are more common in people with MS than in the general population. You can read more about migraine, cluster headaches and tension type headaches on the NHS Choices web site. There is also information on other causes of headache.
Headache can be just one type pain that people with MS may experience. If you are experiencing frequent headaches or other pain you could speak to your MS specialist team or GP. They may be able to help directly or may refer you to specialist support.
You can read more about pain in MS and the treatments that can help in the A-Z of MS.
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