It is generally accepted that migraine is more common in people with multiple sclerosis
(PwMS;
Mrabet et al., 2022
), but is this simply the chance association of two common disorders? Two large meta-analyses
estimated the prevalence of migraine in PwMS at about 31% (
Mirmosayyeb et al., 2020
;
Wang et al., 2021
). Shared features include being White, female, and having a diagnosis in early adult
life. It has been proposed that migraine might be a causal risk factor for MS (
Kister et al., 2012
), who documented a small but significant increased risk of MS (29%) in females at
baseline, compared to those without migraine. The authors (
Kister et al., 2012
) debate whether the higher rate of migraine in PwMS is due to errors in diagnosis
of MS in migraine sufferers. Thus, women with migraine are more likely to be seen
by a neurologist who arranges a brain scan that suggests MS based on non-specific
white matter changes that are common in migraine. Alternatively, migraine-like headache
may be a presenting symptom of MS or part of the MS prodrome (
Tremlett et al., 2022
). Both explanations were considered unlikely, and it is concluded that because migraine
generally predates MS by many years, and migraine at MS onset is rare, suggests that
migraine is more likely a pre-existing diagnosis.Keywords
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Article info
Publication history
Published online: May 22, 2023
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