Gebhardt Marcel, Kropp Peter, Hoffmann Frank, Zettl Uwe K
Krankenhaus Martha-Maria Halle-Dölau, Klinik für Neurologie, Röntgenstraße 1, 06120 Halle, Germany.
Institute of Medical Psychology and Medical Sociology, Medical Faculty, University of Rostock, Gehlsheimer Straße 20, 18147, Rostock, Germany.
Curr Pharm Des. 2022;28(6):445-453. doi: 10.2174/1381612827666210922114100.
For decades, the headache was not considered a typical symptom of multiple sclerosis (MS) and was construed as a "red flag" for important differential diagnoses such as cerebral vasculitis. Meanwhile, several studies have demonstrated an increased prevalence of headaches in MS compared to the general population. This is due to the heterogeneity of headache genesis with frequent occurrence of both primary and secondary headaches in MS. On the one hand, MS and migraine are often comorbid. On the other hand, secondary headaches frequently occur, especially in the course of MS relapses. These are often migraine-like headaches caused by inflammation, which can improve as a result of MS-specific therapy. Headaches are particularly common in the early stages of chronic inflammatory CNS disease, where inflammatory activity is the greatest. In addition, headaches can also occur as a side effect of disease-modifying drugs (DMDs). Headache can occur with most DMDs and is most frequently described with interferon-beta therapy. The aim of this work is to present the prevalence of headaches and describe the heterogeneity of possible causes of headaches in MS. In addition, important therapeutic aspects in the treatment of MS patients, in general, will be presented as well as different approaches to the treatment of headaches in MS depending on the etiological classification.
几十年来，头痛一直不被视为多发性硬化症（MS）的典型症状，而是被视为诸如脑血管炎等重要鉴别诊断的“警示信号”。与此同时，多项研究表明，与普通人群相比，MS患者中头痛的患病率有所增加。这是由于头痛成因的异质性，MS中原发性和继发性头痛都经常出现。一方面，MS与偏头痛常合并存在。另一方面，继发性头痛也经常发生，尤其是在MS复发过程中。这些头痛通常是由炎症引起的偏头痛样头痛，可通过MS特异性治疗得到改善。头痛在慢性炎症性中枢神经系统疾病的早期阶段尤为常见，此时炎症活动最为强烈。此外，头痛也可能作为疾病修饰药物（DMDs）的副作用出现。大多数DMDs都可能引发头痛，其中以干扰素-β治疗时最为常见。这项工作的目的是介绍MS患者中头痛的患病率，并描述头痛可能成因的异质性。此外，还将介绍MS患者治疗中的重要治疗方面，以及根据病因分类对MS患者头痛进行治疗的不同方法。
