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MS and Migraines: Is There a Link?

Medically Reviewed by Jennifer Robinson, MD on June 26, 2020

Research shows that people with MS tend to have more headaches, including migraines, than others. But scientists aren’t sure if headaches are a symptom of MS, or if the two conditions sometimes just happen to the same people.

The two conditions have different causes, but they share some symptoms. MS happens when your immune system attacks myelin, a protective coating for your nerves. This can cause vision problems, pain, tingling, and weakness.

Scientists don't know exactly what causes migraines. But they think chemicals and hormones in your body play a role. Along with intense head pain and nausea, migraines sometimes cause visual symptoms called auras. You may see spots, sparkles, or zigzag lines. You might feel tingling, weakness, and dizziness.

Cause or Chance?

Lots of people -- 12% of the population -- have migraines. But people with MS are more than twice as likely to get migraines, and all headaches, than others.

In some situations, MS can lead to migraines. But sometimes, the two conditions aren't related. It's tricky. Consider:

  • Most people who have MS and migraines had headaches before they were diagnosed with MS.
  • Others never had a migraine before their first MS symptoms showed up.
  • Some never learn they have MS until a bad headache leads them to get imaging tests on their brain.

 

Other Links Between MS and Migraines

Even when MS doesn’t directly cause your migraines, some aspects of the condition can make headaches more likely, or more painful. They include:

  • MS flare-ups. MS symptoms tend to come and go. People who get migraines often get more of them during an MS flare, especially migraines with auras.
  • MS treatments. You might never have a migraine until you start taking certain MS medications. Even if you have, your MS drugs might trigger your headaches just like some foods or weather changes.
  • Emotional aspects of MS. Anxiety and stress from having MS can lead to migraines.
  • Brainstem damage. Migraines are thought to start in the brainstem, a part of the brain where nerve injury from MS often happens. That damage can lead to migraines.
  • Swollen optic nerve. Your optic nerves, which are found behind your eyes, can swell due to MS. This may make your head hurt so badly it feels like a migraine. But it isn’t.

Scientists have some other theories about the link between the two conditions. One study found that brain inflammation caused by migraines could put you at higher risk for MS. Another possibility is that migraines cause changes in levels of serotonin (a hormone) in your brain that raise your chances for MS. But there's little evidence for these ideas.

Treatment and Prevention Tips

If you have MS and get a migraine, tell your doctor. Some doctors focus so much on your MS symptoms that they don’t ask if you have migraines. This means you may not get the right treatment for your headaches.

When you talk to your doctor, they can help you figure out if your migraines are related to your MS medications, damage in your brainstem, or an MS flare. Your doctor may change your MS treatment if it makes your migraines worse. If your migraines signal MS flares, your doctor can treat you to prevent a flare-up when you tell them you have a headache.

Other ways to help stop migraines or reduce the pain:

WebMD Medical Reference

Sources

SOURCES:

International Journal of MS Care: “Headache in Multiple Sclerosis: Features and Implications for Disease Management.”

MultipleSclerosis.net: “Migraines and MS.”

Multiple Sclerosis Foundation: “MS and Headaches,” “MS and Migraine: More Than Meets the Eye.”

PLOS One: “Meta-Analysis of the Relationship Between Multiple Sclerosis and Migraine.”

Johns Hopkins Medicine: "How a Migraine Happens."

Mayo Clinic: "Migraine with aura."

Migraine Research Foundation: "Migraine Facts."

Multiple Sclerosis Association of America: "The Multiple Sclerosis Process and Symptoms."

Current Treatment Options in Neurology: "Headache and Its Management in Patients With Multiple Sclerosis."

International Journal of Neurology: "The Co-Occurrence of Multiple Sclerosis and Migraine Headache: The Serotoninergic Link."

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