Abstract: Objective To investigate the association between primary headaches and multiple sclerosis(MS). Methods One hundred and seventy-one MS patients were enrolled and divided into two groups, headache group(51 cases)and non headache group(120 cases). MS form, duration, radiology and occurrence of other related diseases in the two groups were retrospectively analyzed and compared. Features and incidence of subtypes of primary headaches in non headache group were also analyzed. Results 29.8% MS patients were accompanied by primary headaches. Two-thirds of patients reported headaches before occurring of MS symptoms. Throbbing and tightening pain were common, mainly appeared in the bitemporal and occiput. Pain often lasted for more than 4 hours, attacked frequently and severely. Most of the patients in headache group showed more than 3 lesion locations(90.2%), which were more common in the brainstem, thalamus and corpus callosum than those of non headache group. Of primary headaches, migraine(47.1%)was the most common type, observed more often in young relapsing-remitting MS(R-R MS)patients. While, secondary progressive MS(SP MS)patients was often accompanied by tension-type headache, who were older than migraine patients(P<0.05). The patients in headache group were more likely combined with cerebral infarction than those in non headache group(P<0.05). Conclusion Nearly one-third of MS patients are accompanied by primary headaches, of which migraine is the most common type. The headaches are often serious. These patients always have more demyelinating lesions than those without headaches, and the lesions mainly locate in the brain stem.

Key words: Migraine primary headaches, Multiple sclerosis, Magnetic resonance imaging