Contributions
Abstract: EP1449
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Comorbidity
Background: High prevalence of migraine in patients with multiple sclerosis (pwMS) has been supported by abundant controlled and uncontrolled studies. Yet; the temporal association, headache semiology and MS characteristics of those patients remain to be determined.
Objectives: To investigate the prevalence and characteristics of headaches in MS sample vs. control healthy subjects and to compare the MS-headache group (MS-H) with headache-free MS (MS-NH) patients with respect to MS type, symptoms and disease-modifying drugs (DMD) intake.
Methods: A cross sectional, case-control study that included 486 MS patients (non-probability convenient sampling method). The control subjects (n=486) were selected among patients' accompanying friends with age and gender matching. All participants were screened for the presence of headache in the last year (1-year prevalence) using a validated Arabic-language headache questionnaire and migraine severity was assessed using the Migraine Disability Assessment (MIDAS).
Results: We detected 309 (63.58%) pwMS and 245 (50.72%) controls had ''headache within the past year”. Headache was more in secondary progressive (SPMS) than in relapsing remitting (RRMS) patients (71.29% vs 51.02%; p=0.03) and was associated with higher EDSS scores (p=0.04). The migraine frequency was higher in pwMS (45.11 vs 21.67%; prevalence ration (PR): 2.08, p=0.02). Unclassified headache (according to International Headache Society criteria) was more in pwMS (23.71% vs 11.56%; PR: 2.05). Migraine without aura was more frequent in pwMS than migraine with aura but disability (assessed with MIDAS) did not differ between pwMS and controls. According to temporal relationship of headache onset and MS milestones; headaches were classified into; (1) headache preceding MS (n=191/309; 61.81%), (2) headache associated with initial presentations of MS (n=33; 10.68%); (3) headaches developed within the course of MS (whether first presented in relationship to attacks or not) in 46 (14.89%) and (4) headache started after initiation of DMD (n=39; 12.62%). Of our patients, 365/486 (75.10%) were on DMD; which had variable effects on headaches: headache de novo (10.68%) improvement (27.67%), worsening (26.03 %) and remained unchanged (35.62%).
Conclusion: Headache is more common in MS patients than in controls. Patients with MS-H can be classified according to its temporal relations of MS onset, which may help in resolving the underlying mechanism(s) of this association.
Disclosure: Sherif Hamdy. Nothing to disclose
Maged Abdel-Naseer. Nothing to disclose
Hatem S. Shehata. Nothing to disclose
Mona Nada. Nothing to disclose
Alaa Elmazny. Nothing to disclose
Amr Hassan. Nothing to disclose
Nevin Shalaby. Nothing to disclose
Abstract: EP1449
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Comorbidity
Background: High prevalence of migraine in patients with multiple sclerosis (pwMS) has been supported by abundant controlled and uncontrolled studies. Yet; the temporal association, headache semiology and MS characteristics of those patients remain to be determined.
Objectives: To investigate the prevalence and characteristics of headaches in MS sample vs. control healthy subjects and to compare the MS-headache group (MS-H) with headache-free MS (MS-NH) patients with respect to MS type, symptoms and disease-modifying drugs (DMD) intake.
Methods: A cross sectional, case-control study that included 486 MS patients (non-probability convenient sampling method). The control subjects (n=486) were selected among patients' accompanying friends with age and gender matching. All participants were screened for the presence of headache in the last year (1-year prevalence) using a validated Arabic-language headache questionnaire and migraine severity was assessed using the Migraine Disability Assessment (MIDAS).
Results: We detected 309 (63.58%) pwMS and 245 (50.72%) controls had ''headache within the past year”. Headache was more in secondary progressive (SPMS) than in relapsing remitting (RRMS) patients (71.29% vs 51.02%; p=0.03) and was associated with higher EDSS scores (p=0.04). The migraine frequency was higher in pwMS (45.11 vs 21.67%; prevalence ration (PR): 2.08, p=0.02). Unclassified headache (according to International Headache Society criteria) was more in pwMS (23.71% vs 11.56%; PR: 2.05). Migraine without aura was more frequent in pwMS than migraine with aura but disability (assessed with MIDAS) did not differ between pwMS and controls. According to temporal relationship of headache onset and MS milestones; headaches were classified into; (1) headache preceding MS (n=191/309; 61.81%), (2) headache associated with initial presentations of MS (n=33; 10.68%); (3) headaches developed within the course of MS (whether first presented in relationship to attacks or not) in 46 (14.89%) and (4) headache started after initiation of DMD (n=39; 12.62%). Of our patients, 365/486 (75.10%) were on DMD; which had variable effects on headaches: headache de novo (10.68%) improvement (27.67%), worsening (26.03 %) and remained unchanged (35.62%).
Conclusion: Headache is more common in MS patients than in controls. Patients with MS-H can be classified according to its temporal relations of MS onset, which may help in resolving the underlying mechanism(s) of this association.
Disclosure: Sherif Hamdy. Nothing to disclose
Maged Abdel-Naseer. Nothing to disclose
Hatem S. Shehata. Nothing to disclose
Mona Nada. Nothing to disclose
Alaa Elmazny. Nothing to disclose
Amr Hassan. Nothing to disclose
Nevin Shalaby. Nothing to disclose