BOSTON—At Island Neurological Associates in Pla- inview, New York, researchers uncovered a prevalence of chronic migraine among their population of
patients with multiple sclerosis (MS) that was higher
than would be expected in the general population.
They reported their results at the 59th Annual Scientific Meeting of the American Headache Society. “Since
migraine as a whole is generally accepted to occur in
about 12% of the population, it appears that our MS
patient prevalence of 21% significantly exceeds this
[prevalence],” said Ira Turner, MD, a headache subspecialist at the Long Island facility. Similarly, “chronic
migraine is thought to occur in 1% to 2% of the general
population, but [it occurs] in 7% of our MS population,”
Dr. Turner said.
Observing that MS and migraine are both chronic
neurologic conditions in which inflammatory processes play an important role, Dr. Turner and colleagues
sought evidence for increased migraine prevalence in
the MS population. “Anecdotally, it has been our experience that there is a comorbidity of headache disorders in
our MS patient population,” Dr. Turner said.
The investigators conducted a retrospective review
of the electronic medical record (EMR) system at their
community-based Comprehensive MS Center and Cen-
ter for Headache Care and Research. They reviewed the
EMR for all patients with a diagnosis of any form of
MS. The EMR was then queried to determine which of
the patients with MS had any headache diagnosis listed
as a comorbidity. Those headache diagnoses were then
reviewed and separated into those that met ICHD- 3 be-
ta criteria for chronic migraine, episodic migraine with
aura, episodic migraine without aura, episodic cluster
headache, chronic cluster headache, tension-type head-
ache, or a nonspecific diagnosis of headache.
The researchers found 610 active patients with a diagnosis of MS. Of these, 139 (23%) also had a headache
diagnosis listed in the EMR as a comorbidity. Migraine
without aura was coded in 62 patients (10%), migraine
with aura in 26 (4%), and chronic migraine in 45 (7%).
Combining these diagnoses yielded a prevalence of comorbid migraine of 21% in the MS population studied.
Episodic cluster headache was diagnosed in one patient,
tension-type headache in two patients, and nonspecific
headache in four patients. The prevalence of these three
diagnoses was less than 1% each.
“While there is a potential bias caused by our practice having both an MS center and a headache center,
this increased prevalence seems to be of great interest
and would appear to warrant further investigation,”
Dr. Turner said. NR
—Glenn S. Williams
Is Chronic Migraine More
Common in the MS Population?
A single-center study finds a higher-than-expected prevalence of chronic migraine among
its population of patients with MS.