Being diagnosed with multiple sclerosis leads to a lot of life changes, most of which are necessary to help manage symptoms during a relapse. However, in order to understand what changes should be made, a diagnosis must first be determined. Patients fearing they may have developed the neuro-degenerative disease go through a battery of tests to determine whether or not the diagnosis is accurate prior to treatment, mainly because there are dozens of other diseases and conditions that initially look like MS.
In fact, a patient who has migraines may experience some very similar symptoms to someone who has developed multiple sclerosis. It’s essential to make the determination prior to prescribing any treatment, since some of the treatments for one of the diseases could be detrimental to patients suffering from the other. It could take time to distinguish which is the culprit, though, based on the similarities.
What are migraines?
A migraine is more than just a headache. While some “traditional” headaches can seem debilitating, they are not the same as a migraine. With a migraine, the individual experiences severe pain the head, which often occurs only on one side but could affect both sides at the same time. This pain can be accompanied by other issues, as well, including extreme sensitivity to light or sound, as well as nausea and vomiting. Any sort of activity often exacerbates the symptoms, and migraines usually last several hours or even days without treatment.
The reason behind migraines is not fully understood in science, but migraine triggers can be:
- Hormonal changes (such as during menstruation)
- Emotional issues (brought on by stress, anxiety, or excitement)
- Physical ailments (such as lack of sleep or uncontrolled blood sugar)
- Diet (anything from alcohol and caffeine to irregular mealtime and chocolate could be listed as triggers)
- Medication (HRT, contraceptives, sleeping pills etc.)
- Environmental (smells, sounds, temperature changes, bright or flickering lights, and more)
Depending on the patient, triggers can vary greatly, which means the list is quite long.
Multiple sclerosis and migraines: symptoms and similarities
While it may seem that there are vast differences between multiple sclerosis and migraines – and in some ways, there are – it’s easy to confuse the two in the beginning based on similar symptoms and presentation.
- Both may have visual symptoms, including optic neuritis (swelling of the optic nerve), which leads to blurred vision, double vision, and perhaps some blindness in varying degrees
- Both migraines and MS are chronic and often appear as relapses following a period of remission, rather than remaining constant. Duration may be different, depending on the patient. With multiple sclerosis, a relapse lasts at least twenty-four hours, and there is usually at least a period of thirty days of remission. Migraines could be shorter or longer and may be more frequent but still come and go.
- They are both triggered into a relapse by a medical or environmental condition. Stress especially is an overlapping trigger for relapses of both migraine and multiple sclerosis. Anxiety, some dietary issues, lack of rest and exhaustion, and hormonal changes are other common triggers between the two.
- The manifestation of migraines and MS are both as unique as the individual experiencing them. No two cases are the same, which only makes it more difficult to distinguish, since symptoms could be altogether different, appear at different stages, or be completely absent from a particular patient.
- Both are believed to affect the brain stem, which is part of the central nervous system. Multiple sclerosis attacks the entire CNS, including the brain, brain stem, spinal cord, and optic nerve. However, migraines seem to emit from the brain stem, as well as having effects on the optic nerve, meaning that several symptoms could be the same. In fact, migraine could be a symptom of multiple sclerosis for some individuals.
The fact that migraines occur almost three times as frequently in patients with MS jut goes to show a major overlap and connection between the two. Still, the two ailments are not the same thing.
Migraines and multiple sclerosis: conditions and differences
In a study in 2016, twenty-two percent of patients who had previously been diagnosed with multiple sclerosis were found to have been misdiagnosed, many of which actually had chronic migraines (some of them also manifesting with additional ailments). Because of such hefty amounts of people being treated for the wrong disease, it’s extremely important to recognize the differences so this doesn’t continue, especially since treatment for MS has been shown to often trigger migraines.
- One of the latest ways to determine the difference between multiple sclerosis and migraines as a diagnosis is the interpretation of the MRI. Both conditions present with lesions in the brain, which could easily be misinterpreted and misdiagnosed. However, recent studies show that lesions in MS typically center around veins, while migraine lesions do not. This has previously been missed due to lack of availability of the technology required to see it in many clinics and hospitals.
- Observation of the size of the thalamus (the gray matter between brain hemispheres) has shown that patients with MS have reduced size, whereas patients without don’t have this difference, helping to separate migraine from a diagnosis of MS.
- New technology can help separate cortical and subcortical (outer versus inner layers of the cerebrum) lesions. When cortical lesions are present, this is more indicative of MS than migraines.
- Treatment for multiple sclerosis involves corticosteroids and other anti-inflammatories, immunosuppressants, and disease modifying therapies (DMTs). While anti-inflammatory agents may help with migraine paint (such as ibuprofen), there is no specific treatment for migraines, though over the counter pain medications may help. There are also some preventative methods under review, such as the use of antidepressants, coenzyme Q10 supplements, magnesium citrate, riboflavin, vitamin B12, and other supplements that could help reduce the onset of a migraine.
For both multiple sclerosis and migraines, the exact cause is still a mystery, and though there are treatments employed, there is no known cure for either. Since both affect the nervous system (mainly through the brain stem and optic nerve, with MS also attacking the rest of the CNS), it’s important to speak with a physician about symptoms in order to get a diagnosis. The sooner treatment is implemented, the better the prognosis. Though migraines are not degenerative, they can be debilitating and cause just as much interruption in quality of daily life and MS, so getting help can make a huge difference in the ability to function and be independent.