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Nervenheilkunde 2011; 30(07): 476-479
DOI: 10.1055/s-0038-1628382
Multiple Sklerose
Schattauer GmbH

Kopfschmerzen und Multiple Sklerose

Headache and multiple sclerosis
M. Marziniak
1   Klinik und Poliklinik für Neurologie, Abteilung für Entzündliche Erkrankungen des Nervensystems und Neuroonkologie, Universität Münster
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Publication History

Eingegangen am: 11 March 2011

angenommen am: 18 April 2011

Publication Date:
23 January 2018 (online)

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Zusammenfassung

Diese Übersicht berichtet über die Assoziation von Multipler Sklerose (MS) und Migräne, Spannungskopfschmerzen, Trigeminusneuralgie und den durch die immunmodulatorische Therapie verursachten Kopfschmerz. Die Migräneprävalenz in MS-Patienten liegt zwischen 20 und 45% und unterscheidet sich aufgrund von regionalen Besonderheiten, dem Geschlecht und der Art der immunmodulatorischen Therapie. In einigen Untersuchungen scheint insbesondere die Migräne mit Aura ein Risikofaktor für das Auftreten und ein Prädiktor für eine frühe Manifestation der MS zu sein. Spannungskopfschmerzen bestehen bei MS-Patienten nicht gehäuft. Kopfschmerzen sind bis zu fünfmal häufiger unter einer Therapie mit Beta-Interferonen als unter Glatirameracetat. Eine kurzzeitige Gabe von Koanalgetika bewirkt eine Verbesserung der Kopfschmerzen nach Beta-Interferon-Injektion. Eine Trigeminusneuralgie tritt bis zu dreimal häufiger bei MS-Patienten, in bis zu 18% aller betroffenen Patienten auch bilateral auf und ist häufig symptomatisch. Die Daten bezogen auf die Assoziation MS und Kopfschmerzen sind vielfach noch lückenhaft, sodass große populationsbasierte Studien mit Kontrolle der Konfounder sinnvoll erscheinen.

Summary

This review reports about the association of multiple sclerosis (MS) and migraine, tension type headache, trigeminal neuralgia, and headache induced by immunomodulatory therapy. The prevalence of migraine in patients with MS is between 20 and 45% and differs due to regional variations, sex and the kind of immunomodulatory therapy. According to several studies, especially migraine with aura seems to be a risk factor for the occurrence of MS and a predictor for an early manifestation of MS. The prevalence of tension type headache seems to be not increased in patients with MS. Headache occurs five times more often under a therapy with betainterferon than with glatiramer acetate. A short intake of analgesics can improve the immunotherapy related headache. A trigeminal neuralgia is three times more often in MS patients and is in up to 18% of the patients with trigeminal neuralgia and MS bilateral and often due to a symptomatic brain stem lesion. In conclusion, the existing data of the association of MS and headache are still incomplete, therefore larger population based studies with control of confounder effects are required.

Schlüsselwörter

Multiple Sklerose - Migräne - Spannungskopfschmerzen - Beta-Interferon

Keywords

Multiple sclerosis - migraine - tension type headache - beta interferon
 

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