Paliatívna medicína a liečba bolesti 1/2011

Headache and multiple sclerosis

Headache is not generally considered as a symptom of multiple sclerosis (MS). Several studies, however, have confirmed that headache is more common in MS patients when compared to control groups or general population. Its occurrence is reported in 4 % to 61.8 %, depending on individual studies. Headache may be the first sign of MS or may be manifested in the course of the disease. The most common type of headache in MS patients is migraine without aura and tension-type headache; cluster headache is less frequent. Less well-recognized but highly characteristic is intense headache in the nape of the neck associated with acute demyelination affecting fossa posterior structures. In MRI scans, headache may be associated with massive occurrence of large supratentorial inflammation lesions or lesions located in the pons area. Headache is also present as part of interferon treatment, and with simultaneously occurring depression. Since MS patients are more susceptible to headaches, preventive treatment aimed at alleviating distress and improving the quality of life is recommended.

Keywords: headache, multiple sclerosis, migraine, trigeminal neuralgia, demyelinating lesion, MRI, interferon treatment.