The relationship between multiple sclerosis (MS) and headache disorders is not well understood, and studies exploring that relationship have produced conflicting results. A new study reported in Cephalalgia concludes that frequency of headaches is higher in the MS population than the general population, leading researchers to hypothesize a possible association between MS and headache disorders.

Multiple sclerosis is a chronic disease of the central nervous system marked by a wide range of symptoms from annoying symptoms such as mild tingling to debilitating symptoms such as blindness and paralysis. Headache is generally not a symptom of MS.

Researchers interviewed 101 MS patients in Catania, Sicily, to determine how many of them also had headache disorders under the established International Headache Society's International Classification of Headache Disorders. Of the 101 participants:

  • 28 (27.7%) fit the criteria for tension-type headache.
  • 20 (19.8%) fit the criteria for Migraine.
  • four (4%) fit the criteria for secondary headache, which is headache caused by another condition.
  • six had "headaches" that were unclassifiable.

The researchers also assembled a control group of 101 subjects without MS and interviewed them to determine the number of them with headache disorders. Of the 101 participants in the control group:

  • 17 (16.8%) fit the criteria for tension-type headache.
  • 16 (15.8%) fit the criteria for Migraine.
  • five had "headaches" that were unclassifiable.

Authors' conclusions:

"The increased risk of primary headache [not caused by another condition] in our MS cohort supports the hypothesis of a common pathway between these conditions; as suggested by other studies, the higher frequency of headache in MS subjects could be related to brainstem lesions. However, it should be noted that the role of brainstem in migraine pathogenesis is still controversial, and other types of study are needed to confirm this hypothesis."1

Summary and comments:

This small study did show a higher prevalence of Migraine and other primary headaches among the study participants with multiple sclerosis. This is a good start, but larger studies need to be conducted to confirm the conclusions. Their hypothesis of a common pathway (the way the diseases work in the brain) highlights the need for more basic disease research into the causes of both diseases and how they affect the brain.


1 A Nicoletti, F Patti, S Lo Fermo, A Liberto, A Castiglione, P Laisa, A Garifoli, F La Naia, D Maimone, V Sorbello, D Contrafatto, M Zappia. "Headache and multiple sclerosis: a population-based case-control study in Catania, Sicily." Cephalalgia; Volume 28, Issue 11 , Pages1163 - 1169.

2 Reuters Health. "Multiple sclerosis seen associated with headache." December 3, 2008.