Multiple Sclerosis and Migraine

A recent meta-analysis has shown that there is a significant association between migraine and multiple sclerosis (MS). Those with MS are more than twice as likely to report migraine as controls.

The mechanism behind any association between MS and migraine remains to be determined but a number of hypotheses exist. Migraine often precedes MS by numerous years and so migraine could be a potential risk factor for MS. It is also is possible that migraine may result from early MS lesions.

There is evidence for a migraine-inducing role of interferon beta. Other disease modifying therapies, such as glatiramer acetate and natalizumab, do not appear to worsen migraine. Indeed, some patients may want to take this into consideration, as switching from interferon beta may help reduce both the frequency and severity of migraine.¹ Furthermore, stress and anxiety-which often accompany MS-are thought to be very likely causes of increased migraine frequency.

Before any of the above hypotheses can be confirmed, more studies specifically investigating whether MS precedes migraine or vice versa would be necessary to determine whether migraine is as a risk factor, comorbidity, or symptom of MS.

Nevertheless, the underappreciated finding that migraine is more common in MS patients needs to be considered because these headaches are a major potential cause of a poorer quality of life. For that reason, migraine should be actively looked for and managed.

Reference:

1. Villani V, Prosperini L, De Giglio L, et al. The impact of interferon beta and natalizumab on comorbid migraine in multiple sclerosis. Headache. 2012;52:1130-1135.