More MS news articles for Nov 2001

Does Multiple Sclerosis Cause Headache?


Is multiple sclerosis (MS) in and of itself ever an etiology for headache? If so, what is the pathophysiology and reasonable treatment?

from Rohit Bakshi, MD, 10/30/01

MS is commonly associated with headaches, with a prevalence of approximately 12% to 52%. Sometimes, the headaches are associated with specific brain lesions seen on MRI, such as large, supratentorial, tumorlike plaques or lesions in the pons. However, in most cases, the headaches are present without predictable MRI correlations.

Patients with MS may also develop headaches during bouts of optic neuritis. These are typically unilateral and worsened by eye movement. Other causes for headaches in MS patients are cervical paraspinal spasm (tension headache), migraine, or depression. There is no evidence indicating that headaches in patients with MS require treatment different from that for similar headache syndromes not associated with MS. In my experience, most patients respond to nonsteroidal anti-inflammatory agents or antidepressants and migraine-specific agents, if indicated. In selected cases, referral to a pain specialist may be helpful.

Suggested Reading

Bakshi R, Glass J, Louis DN, Hochberg FH. Magnetic resonance imaging features of solitary inflammatory brain masses. J Neuroimaging. 1998;8:8-14.

Kramer R. Treatment of chronic pain. In: Rudick RA, Goodkin DE, eds. Multiple Sclerosis Therapeutics. London: Martin Dunitz; 1999:541-546.

Matthews WB, Compston A, Allen IV, Martyn CN. McAlpine's Multiple Sclerosis. New York: Churchill Livingstone; 1992:71.

Paty DW, Ebers GC. Clinical features. In: Paty DW, Ebers GC, eds. Multiple Sclerosis. Philadelphia: FA Davis; 1998:135-191.

Rolak LA, Brown S. Headaches and multiple sclerosis: a clinical study and review of the literature. J Neurol. 1990;237:300-302.