Migraine and MS

People living with multiple sclerosis (MS) can face many symptoms like pain, fatigue, and mood changes. Some people with MS also have migraine attacks. Migraine and MS have some similarities and overlapping symptoms.^1,2

Living with MS and migraine can be difficult. But there are many treatment options to help manage migraine while living with MS.^1,2

What is migraine?

Migraine is a common neurological (nerve) disease that can affect the entire body. Most people think of migraine as a bad headache. It can be. A migraine attack can cause other disabling symptoms too.³

A migraine headache usually causes medium to severe pain on one or both sides of the head. The pain may feel like it is throbbing. The head pain can last a few hours or several days. Classic migraine attack symptoms include:^3,4

• Nausea
• Vomiting
• Sensitivity to sound, light, and smell

Some people have migraine with aura. Aura is a sensory disturbance that usually occurs before an attack. Visual auras, like flashing lights or spots, are the most common.⁴

Migraine can impact the whole body. During an attack, people may experience other symptoms like:³

• Vertigo
• Mood changes
• Trouble thinking
• Sinus issues
• Vision problems
• Motion sickness
• Tingling or numbness

Migraine is the second leading cause of disability worldwide. It impacts about 10 percent of the world’s population.^4,5

What is the connection between MS and migraine?

The relationship between MS and migraine is unclear. But experts do know that:^2,6,7

• Migraine is more common among people with MS than the general public
• About 31 percent of people living with MS also have migraine
• Migraine is a common comorbidity of MS, meaning they often occur in the same person
• There is no evidence that migraine causes MS

A 2023 study shows migraine and MS share many genetic variants. That could explain why some people have both conditions.⁷

There is some evidence that MS lesions (damage to the nerves) may cause headache or migraine in some people.⁸

Migraine and MS similarities

Migraine and MS have some things in common, including:^2,6-8

• Both disorders impact the nervous system.
• Both affect women more than men.
• Both disorders affect a similar population: women of childbearing age.
• Hormones play a role in both disorders.
• Both have genetic and environmental risk factors. They share some lifestyle risk factors like obesity and smoking.
• Both are ongoing (chronic) disorders.
• Depression often impacts people with both disorders.

MS and migraine have overlapping symptoms. Some of these are:^2,3,7,9

• Numbness, tingling, or pain
• Eye pain, vision problems, or visual disturbances
• Changes in mood and thinking (cognition)
• Fatigue
• Vertigo, dizziness, or problems walking
• Digestive tract issues
• Temperature sensitivity

Can MS treatments trigger a migraine attack?

Some drugs used for MS treatment can cause headaches, make headaches worse, or trigger a migraine attack.^2,8

Some disease-modifying therapies include:^2,8

• Interferon-B therapy
• Natalizumab (Tysabri^®)
• Fingolimod (Gilenya^®)

Overusing some pain medicines to treat MS symptoms could trigger additional head pain. This is known as rebound or medication overuse headache.^2,8

How to manage migraine when living with MS

There are many ways to help manage migraine. Using these tools may improve your quality of life. Lifestyle changes that may help include:^2,8,10,11

• Staying hydrated
• Eating a healthy diet
• Keeping a consistent and adequate sleep schedule
• Exercising and staying active
• Managing stress and practicing mindfulness with things like meditation and yoga
• Engaging in cognitive behavioral therapy

Acute or preventive medicines and nerve stimulation are common treatment options for people with migraine.^8,10,11

Some people have luck with complementary and integrative therapies like:^10,11

• Acupuncture
• Biofeedback
• Trigger point injections

You can also try keeping a migraine diary that logs your migraines and symptoms you may have. That way, you can identify any triggers and avoid them moving forward if possible. If you are having a migraine attack:¹⁰

• Apply ice or a cold compress to the painful area
• Lie down in a dark room

Talk to your doctor before starting or stopping any treatment regimens.

Drug treatment options

There are 2 main ways to treat migraine using medicines. These include acute treatment and preventive treatment. Some types of drugs are both acute and preventive treatments.^8,10,11

Acute or abortive migraine drugs include:^8,10,11

• Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen
• Triptans
• Ditans
• Gepants or calcitonin gene-related peptide (CGRP) antagonists
• Certain steroids
• Nausea medicines
• Medicines to help relieve migraine-linked vertigo or dizziness
• Lie down in a dark room

Preventive migraine drugs include:^8,10,11

• Some antidepressants
• Some antiseizure medicines
• Some blood pressure medicines like beta blockers and calcium channel blockers
• Botulinum toxin
• CGRP monoclonal antibodies
• Gepants or CGRP antagonists

Talk to your doctor about possible side effects or interactions between drugs.⁸