Headaches are not a particularly common daily symptom of MS, but when they do occur, there’s a clear pattern. Patients with MS are more prone to cluster headaches than tension headaches, but most prone to migraines: while 10% to 15% of the general population suffers from migraines, over 40% of MS patients meet the criteria for migraine pain.
Since migraine headaches have such a big impact on quality of life, it’s important for MS patients to spot and treat the pain swiftly, so the headaches don’t compound their illness and complicate their lives any further.
Spotting a Migraine
Migraine is a term that’s used quite a bit, but it actually comes with a specific set of symptoms. Although different people may experience the pain differently, migraine headaches often involve:
- Throbbing on one or both sides of the head
- Sensitivity to light and/or sound
- An “aura,” or vision disturbances like blurriness or bright lines
- Nausea, vomiting, or loss of appetite
- Four to 12 hours of pain
- Residual pain and discomfort after the headache has passed
In comparison, cluster headaches generally only affect one side of the head, sometimes right behind the eye, involve nasal pain, tend to hit suddenly and often at night, but have a shorter duration (it’s rare for a cluster headache to last more than three hours). Tension headaches are milder, with tightening or throbbing pain around the whole head or into the base of the skull.
The Link Between MS and Migraines
Studies suggest that MS patients are twice as likely to experience migraine headaches as the general population. In turn, experts suspect a common predisposing factor for migraine and multiple sclerosis.
Migraine as a Cause of MS
While those with migraines seem to be more prone to MS, it’s difficult to say whether the migraines are actually responsible for the onset of the disease. Women who suffer from migraines are around 50% more likely to develop MS down the road, but experts aren’t sure whether the migraines spark the MS, or are simply one of the earliest symptoms of MS. Part of the uncertainty may come down to the similarities between the two conditions:
- Both conditions are usually diagnosed before the age of 50
- Women are far more prone to both conditions than men (MS affects females twice as often as males, and women are three times as likely to develop migraines than men)
- Each condition can alter brain structure and cause brain lesions, which leads to a variety of symptoms
Since they share several characteristics, both biological and environmental factors, diagnosis can be difficult – or in some cases, easier. It’s possible that recurring migraines lead patients to have an MRI, and only then is evidence of MS detected.
Migraine as a Symptom of MS
Medical experts believe that migraines are more likely a symptom, rather than a cause of MS. One explanation points to changes in brain tissue: the brainstem is one of the three main sites of MS lesions, and those lesions can interfere with neuron activity, leading to migraine pain.
Certain medications for MS can trigger migraines, too. Disease-modifying treatments like interferon beta medications (Rebif, Betaseron, and Avonex) have been known to cause and worsen headaches, and some drugs that treat fatigue can bring on a headache, too. But while headaches in general are a common side effect of many drugs, it seems that medication-induced migraines typically only strike those with a history of migraines.