MS and headaches

    
      Re: MS and headaches
    


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Posted by ccfNeuro MD on July 01, 1997 at 18:59:52:

In Reply to: MS and headaches posted by Mary C. Lyneis on June 19, 1997 at 21:52:53:

:
   Are there any known treatments to relieve migraine headaches in a multiple sclerosis patient?  I have physical therapy patients with MS who have headache problems that are severe enough to interfere with their daily living.
   Any help or advice that you may provide would be very much appreciated.
   Mary C. Lyneis, RPT
   Albuquerque, NM
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Dear Mary,
I know of no contraindications to the administration of  most migraine medications.  Medications for the treatment of migraine headaches can be divided into medications that are help reduce the frequency of migraine attacks and medications to relieve a migraine once its begun.   Common prophylactic medications include beta-blockers, calcium channel blockers (both also blood pressure medications) and tricyclics (commonly used for depression).  Blood pressure medications can cause symptoms of dizziness/lightheadedness from a lowering of blood pressure.  Care must be taken in patients who are unsteady on their feet.  Tricyclics can cause urinary retention which can cause problems, especially for some multiple sclerosis patients who already have difficulty with urination.  These prophylactic medications must be taken regularly.  Common abortive medications include nonsteroidal anti-inflammatories (such as Indocin or Motrin) and Imitrex .  Imitrex (generic name sumatriptan) is a relatively new mediation that  can be taken either orally or by injection.  It is effective but care must be taken not to administer this medication to patients with heart disease because it can  (rarely) cause spasm of blood vessels.  Also, Imitrex should not be used with other medications, namely monoamine oxidase inhibitors (MAOIs) and ergotamines.  
The multiple sclerosis patients with headaches that you are seeing may not all have migraines.  There are several types of headaches  Migraine headaches are usually characterized by a throbbing ache and is associated with sensitivity to light, noise and occasionally nausea.  Tension headaches are another common type.   These headaches tend to be more constant and steady in nature.  Tension headaches are treated somewhat differently than migraines.  I suggest that these people with headaches see their physician for appropriate diagnosis and treatment options, which need to be individualized.  If any of them would like to be evaluated at the Cleveland Clinic, we have both a Headache Clinic ( [phone]) and a large Multiple Sclerosis Center, the Mellen Center, which would be appropriate for them to go to.   I hope this has been of help.  
This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options of your specific medical condition.