Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
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.

PubMed Disclaimer

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

References

    1. MS International Federation Map View. 2023. [(accessed on 11 December 2023)]. Available online: https://www.atlasofms.org/map/global/epidemiology/number-of-people-with-ms.
    1. The Lancet Neurology Multiple sclerosis under the spotlight. Lancet Neurol. 2021;20:497. doi: 10.1016/S1474-4422(21)00170-8. - DOI - PubMed
    1. Marrodan M., Bensi C., Pappolla A., Rojas J., Gaitán M., Ysrraelit M., Negrotto L., Fiol M., Patrucco L., Cristiano E., et al. Disease activity impacts disability progression in primary progressive multiple sclerosis. Mult. Scler. Relat. Disord. 2019;39:101892. doi: 10.1016/j.msard.2019.101892. - DOI - PubMed
    1. Marrie R.A., Allegretta M., Barcellos L.F., Bebo B., Calabresi P.A., Correale J., Davis B., De Jager P.L., Gasperi C., Greenbaum C., et al. From the prodromal stage of multiple sclerosis to disease prevention. Nat. Rev. Neurol. 2022;18:559–572. doi: 10.1038/s41582-022-00686-x. - DOI - PubMed
    1. Makhani N., Tremlett H. The multiple sclerosis prodrome. Nat. Rev. Neurol. 2021;17:515–521. doi: 10.1038/s41582-021-00519-3. - DOI - PMC - PubMed