Headaches (H/As) can be a cause for significant comorbidity in patients with multiple sclerosis (MS), according to recent literature review that shows a variable prevalence of H/As in MS patients. Therefore, the treatment of H/As in patients with MS should be addressed in the same fashion as in the non-MS population, which is a combination of pharmacological and non-pharmacological methods. Highlights of the literature review include:

• H/As and MS are more common in women than in men with the ratio of female to male being 3:1.
• It is not entirely clear if there is a correlation or an incidental comorbidity of 2 neurological conditions.
• Using the International Classification of Headache Disorders (ICHD) criteria, the primary type of H/As, especially migraine, is the most common type seen in patients with MS.
• One of the theories of the pathophysiologic mechanisms of migraine in MS patients is inflammation leading to demyelinating lesions in the pain-producing centers in the midbrain.
• Secondary H/As due to MS medications such as interferons are also frequently present.