Multiple sclerosis seen associated with headache

Patients with multiple sclerosis are more apt to suffer from headaches than the general population, results of a study hint.

Multiple sclerosis, or MS, is a disease in which the immune system mistakenly attacks and damages the myelin sheath that protects nerve cells. It can cause symptoms ranging from vague tingling to blindness and paralysis.

"Headache is not generally considered a symptom of MS, and studies investigating the relationship between the two conditions have produced conflicting results," Dr. Mario Zappia, of the University of Catania, and colleagues note in a report published this month.

In a "case-control" study, the researchers screened 101 MS patients and 101 controls for headaches. They found that the frequency of headache was higher in the MS patients than in the control patients.

Among the MS patients, 58 (about 57 percent) fulfilled the diagnostic criteria for headache. Most of these patients were affected by tension-type headache or migraine.

In contrast, 31 (roughly 38 percent) of the 101 controls fulfilled the diagnostic criteria for headache, mostly migraine and tension-type headache.

In an analysis adjusting for age and sex, the researchers observed a significant association between MS and headache. The likelihood of headache was more than twofold higher in the MS patients than in the control patients.

The increased risk of headache in MS patients "supports the hypothesis of a common pathway between these conditions; as suggested by other studies, the higher frequency of headache in MS subjects could be related to brainstem lesions," Zappia's team concludes.

"However, it should be noted that the role of brainstem in migraine pathogenesis is still controversial, and other types of study are needed to confirm this hypothesis."

SOURCE: Cephalalgia, November 2008.