Multiple sclerosis and headache: A further examination of these comorbid conditions in patients receiving care in a multiple sclerosis center: A cross-sectional study

Background: MS and Migraine are comorbid neurologic conditions. Migraine is the world's 2nd most disabling condition per the World Health Organization and its prevalence is three times higher in the MS clinic population compared to the general population. Research shows that patients with MS have more symptoms than MS patients without migraine. Methods: In an ongoing randomized controlled clinical trial of MS patients with 4+ headache days/month, headache histories (including treatments utilized) and varied symptomatology of MS‐headache patients were collected during a baseline interview. Results: 93 patients enrolled; 62 (67%) met ICHD 3 migraine criteria. Of those with MS‐migraine, 55 (89%) were female. Mean age was 39+11. Headaches developed on average at 20+11 years. MS symptoms developed at 27+10 years and MS was diagnosed at 31+10 years. Mean number of headache days/ month was 13+8. Average headache intensity on 0‐10 pain scale was 7+2. Migraine Disability Assessment (MIDAS) scores averaged 39+39. Patients previously used the following for headache management: triptans 37% (23/62), opioids 35% (22/62), oral preventive medications 47% (29/62), botulinum toxin 15% (9/62). Top comorbid conditions were chronic back pain (56%) anxiety (52%), depression (56%). Prevalent MS symptoms: fatigue (95%), weakness (94%), numbness (89%), emotional changes (74%), depression (71%), cognitive decline (73%), difficulty walking (73%), speech (65%), bladder (63%), bowel (45%). Conclusion: In patients in a MS Center with frequent headaches (4+days/month), two thirds had migraine. Headache onset averaged 7 years prior to MS symptom onset. Migraine was highly disabling, and MS symptoms were prominent. Over a third of patients have been on opioids. Top comorbid conditions were chronic back‐pain, depression and anxiety.