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Review
. 2024 Mar 30;60(4):572.
doi: 10.3390/medicina60040572.

Headache in Multiple Sclerosis: A Narrative Review

Bożena Adamczyk  1 , Natalia Morawiec  1 , Sylwia Boczek  1 , Karol Dańda  1 , Mikołaj Herba  1 , Aleksandra Spyra  1 , Agata Sowa  1 , Jarosław Szczygieł  1 , Monika Adamczyk-Sowa  1
Affiliations
Review

Headache in Multiple Sclerosis: A Narrative Review

Bożena Adamczyk et al. Medicina (Kaunas). .

Abstract

Background: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system characterized by autoimmune-mediated damage to oligodendrocytes and subsequent myelin destruction. Clinical implications: Clinically, the disease presents with many symptoms, often evolving over time. The insidious onset of MS often manifests with non-specific symptoms (prodromal phase), which may precede a clinical diagnosis by several years. Among them, headache is a prominent early indicator, affecting a significant number of MS patients (50-60%). Results: Headache manifests as migraine or tension-type headache with a clear female predilection (female-male ratio 2-3:1). Additionally, some disease-modifying therapies in MS can also induce headache. For instance, teriflunomide, interferons, ponesimod, alemtuzumab and cladribine are associated with an increased incidence of headache. Conclusions: The present review analyzed the literature data on the relationship between headache and MS to provide clinicians with valuable insights for optimized patient management and the therapeutic decision-making process.

Keywords: headache; migraine; multiple sclerosis; prodromal syndrome; tension-type headache.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The similarities between MS and migraine headache pathogeneses.
See this image and copyright information in PMC

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Grants and funding

This research received no external funding.