Central Neuropathic Pain: Multiple Sclerosis-Related Headaches

  • Robert Charlson
  • Ilya KisterEmail author
  • Richard Lipton
Part of the Headache book series (HEAD)


A 32-year-old man presents to his neurologist with a history of new-onset right-sided occipital head and neck pain. His medical history is significant for clinically isolated syndrome, anxiety, and frequent migraine headaches since his early twenties. His migraine headaches occur about three times per month and are heralded by typical visual aura half the time. The pain is unilateral usually on the left, pulsatile, and severe. Headaches are associated with prominent nausea and sensitivity to light. Three years ago, he had an episode of right leg weakness, blurry vision in his left eye, difficulty with depth perception, and pain on lateral eye movements that lasted several weeks. On the basis of his symptoms, neurologic deficits, and imaging, clinically isolated syndrome was suspected at the time and he received a course of IV Solu-Medrol with resolution of his symptoms.


Multiple Sclerosis Multiple Sclerosis Patient Trigeminal Neuralgia Migraine With Aura Trigeminal Nucleus Caudalis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

  1. 1.
    D’Amico D, La Mantia L, Rigamonti A et al (2004) Prevalence of primary headaches in people with multiple sclerosis. Cephalalgia 24:980–984PubMedCrossRefGoogle Scholar
  2. 2.
    De Santi L, Annunziata P (2012) Symptomatic cranial neuralgias in multiple sclerosis: clinical features and treatment. Clin Neurol Neurosurg 114(2):101–107PubMedCrossRefGoogle Scholar
  3. 3.
    Foley PL, Vesterinen HM, Laird BJ (2013) Prevalence and natural history of pain in adults with multiple sclerosis: systematic review and meta-analysis. Pain 154:632–642PubMedCrossRefGoogle Scholar
  4. 4.
    Headache classification committee of the International Headache Society (2013) The International Classification of Headache Disorders, 3rd Edition (beta version). Cephalalgia 33(9):777CrossRefGoogle Scholar
  5. 5.
    International Association for the Study of Pain: Taxonomy (2011) URL:
  6. 6.
    Kister I, Caminero AB, Monteith TS et al (2010) Migraine is comorbid with multiple sclerosis and associated with a more symptomatic MS course. J Headache Pain 11:417–425PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Kister I, Munger KL, Herbert J, Ascherio A (2012) Increased risk of multiple sclerosis among women with migraine in the Nurses’ Health Study II. Mult Scler 18(1):90–97PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Lin GY, Wang CW, Chiang TT et al (2013) Multiple sclerosis presenting initially with a worsening of migraine symptoms. J Head Pain 14:70CrossRefGoogle Scholar
  9. 9.
    Mohrke J, Kropp P, Uwe ZK (2013) Headaches in multiple sclerosis patients might imply an inflammatorial process. PLoS One 8(8):e69570PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Moisset X, Ouchchane L, Guy N et al (2013) Migraine headaches and pain with neuropathic characteristics: comorbid conditions in patients with multiple sclerosis. Pain 154:2691–2699PubMedCrossRefGoogle Scholar
  11. 11.
    Nurmikko TJ, Gupta S, MacIver K (2010) Multiple sclerosis-related central pain disorders. Curr Pain Headache Rep 14:189–195PubMedCrossRefGoogle Scholar
  12. 12.
    O’Connor AB, Schwid SR, Herrmann DN et al (2008) Pain associated with multiple sclerosis: systemic review and proposed classification. Pain 137:96–111PubMedCrossRefGoogle Scholar
  13. 13.
    Osterberg A, Boivie J, Thuomas KA (2005) Central pain in multiple sclerosis – prevalence and clinical characteristics. Eur J Pain 9:531–542PubMedCrossRefGoogle Scholar
  14. 14.
    Truini A, Barbanti P, Pozzilli C, Cruccu G (2013) A mechanism-based classification of pain in multiple sclerosis. J Neurol 260:351–367PubMedCentralPubMedCrossRefGoogle Scholar
  15. 15.
    Villani V, Prosperini L, De Giglio L et al (2012) The impact of interferon beta and natalizumab on comorbid migraine in multiple sclerosis. Headache 52:1130–1135PubMedCrossRefGoogle Scholar
  16. 16.
    Wasner G (2010) Central pain syndromes. Curr Pain Headache Rep 14:489–496PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of NeurologyAlbert Einstein College of MedicineBronxUSA
  2. 2.Department of Neurology, Multiple Sclerosis CenterNew York University School of MedicineNew YorkUSA

Personalised recommendations