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How does multiple sclerosis cause migraines?

For most people who have multiple sclerosis (MS) and migraines, the migraines came first and are not caused by the MS itself. Some people, however, had no history of migraines prior to their first MS symptoms. In fact, in some cases, a bad headache led to a first brain MRI (magnetic resonance image) which eventually led to a MS diagnosis. Sometimes, however, migraine may be a symptom of MS or even a sign of a MS relapse.

MS is generally thought to be an autoimmune disease with an inflammatory attack on the myelin covering the nerves and the axons themselves within the central nervous system (CNS). Migraines are believed to be triggered in a part of the CNS called the brain stem. After the spinal cord and optic nerves, the brainstem is one of the three most common sites for the demyelination seen in MS. This means that a MS lesion in the periaqueductal grey matter may cause a migraine.

MS lesions in the optic nerve, which is called optic neuritis, may be very painful and can make someone feel like they are having the explosive eye pain seen in some migraines. In reality this is a MS lesion causing swelling of the optic nerve (the nerve that transmits signals from the eye), which causes this searing pain. People with MS may also have migraines due to various medications they are taking, such as migraines triggered by MS disease-modifying medications, more specifically the beta interferons and fingolimod. While people without a migraine history who take beta interferons may develop headaches as a potential side effect (which also usually improves as the medication is brought up slowly and your body gets used to it), it seems that only people with a personal or family history of migraines actually develop migraines triggered by the MS medications. So, just as many people with migraines have a food or weather trigger for their migraines, MS medications may sometimes be triggers for migraines, as well.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.