The Association of Brainstem Lesions With Migraine‐Like Headache: An Imaging Study of Multiple Sclerosis

Gee, Joey R.; Chang, Joyce; Dublin, Arthur B.; Vijayan, N.

doi:10.1111/j.1526-4610.2005.05136.x

Cited by 131 publications

(113 citation statements)

References 32 publications

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“…Migraine was more frequent in RR and tension type was more frequent in SP, more commonly seen in female patients (26). When MS patients without headaches, MS patients with migraines and non-MS patients with migraines were compared in terms of their MRI findings, MS patients with migraine were seen so have high lesion load in the periaqueductal area (an important region for antinociceptive control) (27). There was headache in 47% of our cases and 2 of them were migraine, 2 were induced by interferon, and the rest were tension type.…”

Section: Discussionmentioning

confidence: 99%

Multipl sklerozda ağrı ve klinik özelliklerle ilişkisi

Akpınar¹,

Tokgöz²,

Gümüş³

2014

tnd

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Objective: Multiple sclerosis (MS) is an autoimmune-neurodegenerative disease of the central nervous system. The prevalence of pain is between 29% and 86% and besides neuropathic pain, somatic pain types may also emerge together or separately. In this study we aimed to analyze the relationship between pain and other clinical features in MS. Ma te ri als and Met hods: One-hundred cases who were followed in MS clinic and who have complaints of pain, were included in this study. We evaluated pain type and localization during patients were filling in the forms. We applied Visual Pain Scale (VPS), Ashworth Spasticity Scale (ASS) and Beck Depression Scale (BDS). Re sults: When female and male patients were compared, there were no statistical differences between age, disease duration and EDDS scores. Seventy seven percent of cases complained of neuropathic pain, 21% of cases had Lhermitte symptoms. Trigeminal neuralgia has been observed in 1% of cases and 55% of neuropathic extremity pain. In 60% of the cases nociceptive pains, in 12% of the cases joint-extremity-muscle pain, in 47% headache and in 1% painful tonic spasms were present. Pain depending on the treatment was observed only in 2% of the cases. The pain score was high in patients with spasticity and depression. Although there was reasonable positive correlation between age, EDDS score and VPS, poor correlation was obtained between disease period and number of attacks. Conclusion: These findings indicate that MS pain is related with spasticity, disability and depression and these clinical findings should be taken into account during pain treatment. (Turkish Journal of Neurology 2014; 20:79-83) Key Words: Multiple sclerosis, pain, neuropathic pain, headache, trigeminal neuralgia Amaç: Multipl Skleroz (MS), santral sinir sisteminin otoimmün-nörodejeneratif bir hastalığıdır. Ağrı prevalansının %29-%86 arasında değiştiği bu hastalıkta nöropatik, somatik ağrı tipleri bir arada veya tek olarak ortaya çıkabilir. Bu çalışmada MS'te ağrı ve diğer klinik özellikler arasındaki ilişkiyi araştırmayı amaçladık. Ge reç ve Yön tem: Çalışmaya MS polikliniğinde takip edilen ve ağrı şikayeti olan 100 olguyu dahil ettik. Olgulara hazırladığımız anket formunu doldurtarak ağrı tipi ve lokalizasyonunu sorguladıktan sonra Vizüel Ağrı Skalası (VAS), Ashworth Spastite Skalası (ASS) ve Beck Depresyon Ölçeği (BDÖ) uyguladık. Bulgular: Kadın ve erkek hastalar karşılaştırıldığında yaş, hastalık süresi, atak sayısı, EDSS skorları arasında istatistiksel olarak anlamlı fark yoktu. Olguların %77'sinde nöropatik ağrı; %21'inde Lhermitte belirtisi, %1'inde trigeminal nevralji, %55'inde nöropatik ekstremite ağrısı vardı. Olguların %60'ında nosiseptif ağrı; %12'sinde yaygın eklem-ekstremite kas ağrısı, %47'sinde baş ağrısı, %1'inde ağrılı tonik spazm mevcuttu. Olguların sadece %2'sinde tedaviye bağlı ağrı vardı. Ağrı skoru, spastisitesi ve depresyonu olanlarda anlamlı derecede yüksekti. Yaş ve EDSS skoru ile VAS arasında orta derecede pozitif korelasyon varken, hastalık süresi ve atak sayısı ile...

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Section: Discussionmentioning

confidence: 99%

Multipl sklerozda ağrı ve klinik özelliklerle ilişkisi

Akpınar¹,

Tokgöz²,

Gümüş³

2014

tnd

View full text Add to dashboard Cite

show abstract

“…Previous studies reported that migraine prevalence is high in MS patients with brainstem demyelinating plaques in the red nucleus [8,9].…”

Section: Discussionmentioning

confidence: 99%

Headache in Multiple Sclerosis From a Different Perspective: A Prospective Study

Özer¹,

Ergün²,

İnan³

2018

J Clin Exp Invest

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Objective: It is known that patients with multiple sclerosis have a high incidence of headache. Although there is increasing evidence to suggest that periaqueductal gray matter (PAG) plays a role in the pathophysiology of migraine headache, it is not known whether the type of headache may be a predictor of a MS relapse. Patients and Methods:The study enrolled 100 patients (68 females, 32 males) with clinically confirmed MS diagnosis established by McDonald diagnostic criteria. The type and duration of MS, MRI localization of lesions and cognitive status were recorded for all patients. Patients were questioned whether they experience headache during MS attacks. Results: Sixty-eight percent of the patients had headache and 32% of the patients were free of headache. Of the patients with headache, 16% had tension -type headache (TTH), 14% had migraine, 11% had primary stabbing headache (PSH), 8% had TTH+ migraine, 6% had PSH+ migraine, 6% had medication overuse headache , 2% had medication overuse headache + migraine, 2% had paroxysmal hemicrania, 1% had cervicogenic headache, 1% had chronic TTH, and 1% had unclassified headache. There was a statistically significant relationship between the presence of headache and MS relapse (p<0.001). We found a statistically significant relationship between the type of headache and the localization of plaques in all MS patients in a statistical analysis using chi-square test, (p<0.001). Conclusion: Headache may be the only symptom of a flare-up in MS patients. The relationship between stabbing headache and MS relapses merits further investigation.

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“…A hypothesis has been proposed, relating MS relapse-onset migraine headache to a possible dysregulation of the 5-HT system in the pathophysiology of MS (Sandyk and Awerbuch, 1994). In a comparative study including migraineurs and MS patients with and without migraine, Tortorella et al (2006) found that MS patients with migraine had more lesions in the red nucleus, substantia nigra and periaqueductal gray matter, thus suggesting a possible localization factor responsible for the presence of migraine in patients with MS. Brainstem and especially midbrain plaques in patients with MS could be associated with an increased likelihood of migraine headache as well (Gee et al, 2005). But while MS patients tend to have migraine or other types of headache as comorbidities, no distinctive "MS headache" can be described, and headache may not correlate with any clinical features of MS (Rolak and Brown, 1990).…”

Section: Introductionmentioning

confidence: 99%

White Matter Lesions in a Patient with Headache – Case Report and Review of the Literature

Dimitrov¹,

Kaprelyan²,

Ivanov³

et al. 2014

IJN

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Magnetic resonance imaging has been widely used to aid the diagnostic process in patients with various disorders of the nervous system. White matter hyperintensities represent a frequent T2-MRI finding. They may be due to multiple sclerosis and other demyelinating diseases, systemic diseases and cerebrovascular disease, among other examples. Such lesions have also been described in patients with migraine. In this paper we present the case of a patient with unilateral headache attacks, accompanied by photophobia and phonophobia, whose MRI scan showed lesions of the cerebral white matter, reported as most likely due to multiple sclerosis. We review the literature on the topic and discuss some possible approaches to the differential diagnosis.

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The Association of Brainstem Lesions With Migraine‐Like Headache: An Imaging Study of Multiple Sclerosis

Abstract: The results of this study indicate that the presence of a midbrain plaque in patients with MS is associated with an increased likelihood of headache with migraine characteristics. (Headache 2005;45:670-677).

Cited by 131 publications

References 32 publications

Multipl sklerozda ağrı ve klinik özelliklerle ilişkisi

Multipl sklerozda ağrı ve klinik özelliklerle ilişkisi

Headache in Multiple Sclerosis From a Different Perspective: A Prospective Study

White Matter Lesions in a Patient with Headache – Case Report and Review of the Literature

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