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Vascular headache: a presenting symptom of multiple sclerosis
1University of Toronto, Department of Neurology, St. Michael's Hospital, Ontario, Canada.
Abstract:
Vascular headache of migraine-type may be a presenting symptom of multiple sclerosis (MS), a condition usually not considered in the differential diagnosis of a severe headache accompanied by neurological signs. We reviewed records of 1,113 patients with MS seen from 1967-1987 and found 44 cases whose initial attack or subsequent exacerbations were heralded by a migraine-type headache. Twenty-seven patients had no prior history of migraine, and of these, 12 presented simultaneously with their first headache and MS attack. Twenty-three patients had symptoms of a posterior fossa mass lesion. The significance of these results and possible pathogenesis is discussed.
Insights
Migraine-type headaches can be an early sign of multiple sclerosis (MS), a neurological condition. This study found that 44 MS patients experienced such headaches, with some presenting them as their first symptom.
Area of Science:
- Neurology
- Neuroimmunology
Background:
- Vascular headaches, specifically migraine-type, are not typically considered a primary symptom of multiple sclerosis (MS).
- MS is a chronic neurological disease affecting the central nervous system.
Purpose of the Study:
- To investigate the occurrence of migraine-type headaches as a presenting symptom or exacerbation in patients with multiple sclerosis.
- To determine the frequency and characteristics of migraine-type headaches in an MS cohort.
Main Methods:
- Retrospective review of medical records from 1,113 patients diagnosed with multiple sclerosis between 1967 and 1987.
- Identification of cases where migraine-type headaches preceded or coincided with the initial MS attack or subsequent exacerbations.
Main Results:
- Forty-four out of 1,113 MS patients experienced migraine-type headaches heralding their disease onset or exacerbations.
- Twenty-seven patients had no prior history of migraine; 12 of these presented with simultaneous headache and MS symptoms.
- Twenty-three patients with migraine-type headaches also exhibited symptoms suggestive of a posterior fossa mass lesion.
Conclusions:
- Migraine-type headaches can be an unrecognized presenting symptom of multiple sclerosis.
- The findings suggest a potential link between migraine-type headaches and MS, warranting consideration in differential diagnoses.
- Further research is needed to explore the underlying pathogenesis and clinical significance.