The Emotional Impact of Living with Migraine and MS

.The emotional impact of living with Migraine and MS simultaneously can often feel impossible to manage. Both these unpredictable and often debilitating neurological diseases are difficult enough to deal with on their own, but together the mental and physical burden can be overwhelming.

A migraine is not just a headache

Migraine is a chronic sympathetic nervous system dysfunction. Evidence shows that the migraine brain is hyperexcitable in between migraine attacks and that during attacks, the brain’s response to certain stimuli like smell, noise, and light is abnormal.

Decreased grey matter has also been reported in the migraine brain and the effects of repeated migraines can lead to brain alterations that affect the subcortical (information hub of the nervous system involved in memory, emotion) and cortical (motor, sensory, visual) systems.1

MS affects more than just nerves

Multiple Sclerosis is a disease of the central nervous system (CNS) affecting the brain and spinal cord and these nerves essentially control the entire body. If communication between the body and brain breaks down then physical and cognitive problems can occur.

Migraine and MS can cause damage that leads to lesions and changes in the brain. They both can cause widespread and disabling symptoms that directly and indirectly impact all parts of a person’s life.

Misfiring nerves and brain lesions are common in Migraine and MS

According to a study published in Neurology, migraines may affect the long-term structure of the brain and increase the risk of white matter brain lesions.

“A migraine is essentially the electrical system of the brain misfiring. This electrical activity causes a change in blood flow to the brain, affecting the brain’s nerves and causing pain.”2

In MS, the body attacks myelin, which is the insulation for the nerves, stripping away its protective coating and damaging the axons which are like the super-highway for nerve conduction that carries messages to and from the brain.  When these nerves misfire, the signals that tell the body what to do, don’t work properly.

Loss of insulation on the nerve cells can lead to inflammation and lesions, and over time can cause brain shrinkage.

Migraine and MS linked

Clinical overlap between migraine and MS has been recognized since 1952, when a study by McAlpine and Compston,  observed that 2% of patients with MS developed migraine within 3 months of an initial relapse.3

Research shows a strong connection between Migraine and MS, with Migraine affecting PwMS 2-3 times more than the general population. Evidence suggests that headaches can vary based on the lesion locations and what kind of MS a person has. Additionally, patients who suffered from migraines with aura strongly correlated with MS exacerbations.

In another study, MS patients with migraines had a more symptomatic clinical course of the disease than the PwMS who did not suffer from headaches.

MS lesions can cause migraines

“Migraines are believed to be triggered in a part of the CNS called the brainstem. The brainstem is one of the three most common sites for the demyelination seen in MS. This means that an MS lesion in the periaqueductal grey matter may cause a migraine.”4

Some MS disease-modifying treatments can trigger migraine

In some people, certain MS medications (beta interferon, natalizumab, and fingolimod) have been shown to trigger migraines or make headaches worse.5  

Migraine and MS can have similar symptoms

Sometimes it’s hard to tell if you are getting a migraine or if you’re having an MS flare as some of the symptoms are the same. These are my migraine symptoms and every one of these can also be symptoms of MS:

  • Weakness
  • Fatigue
  • Blurry vision
  • Facial pain
  • Tingling in the face/head
  • Vertigo
  • Nausea
  • Tinnitus
  • Pain
  • Slurring speech
  • Difficulty finding words
  • Balance issues
  • Stiff neck
  • Frequent urination
  • Vomiting
  • Gastro issues

Stress can trigger Migraine and exacerbate MS symptoms

Frequent and severe stress can cause the protective adaptive responses that maintain a stable state for the brain to become overused and dysregulated. As a result, the brain responds abnormally to stressors and chronic stress can damage the brain.6

Stress is a trigger for migraine in 70% of people, and in one study, 50-70% of people significantly associated daily stress levels with migraine activity.7

In MS, there’s evidence that stressful life events may alter the onset and development of disease activity. One study reported MS flares within the 6 weeks following stressful major life-changing events like job loss, divorce, or death of a loved one.

Another study, published in the British Medical Journal found that following anxiety-triggering events, stress more than doubled the rate of relapse.

Is Migraine a symptom of MS?

I’ve never been able to get a satisfactory answer on whether my migraines are a symptom of my MS or if they are exacerbated because of the MS.

As evidenced above and through many more studies on the subject, there is a Migraine and MS connection. In fact, one small 2017 study showed migraine can be the presenting symptom for MS and that a migrainous subtype of headache is a frequent symptom in the first manifestations of MS. The study also reported that headaches were prevalent in 78% of newly diagnosed patients.

Personally, it was a severe migraine that resulted in vertigo, double vision, and strabismus (eye facing in the wrong direction) that landed me in the ER with an eventual MS diagnosis almost 20 years ago.

The emotional impact of living with Migraine and MS

There is no cure for Migraine or MS and even though there are treatments for both they do nothing to help with the constant worry and anxiety over the fact that these conditions will never go away and that symptoms are hard to control.

Living with the knowledge that life will always be a balancing act of trying to adapt to the daily uncertainty of disruptive, unpredictable, and often painful symptoms while trying to meet the expectations you place on yourself or that others place on you, takes a toll, physically and emotionally.  

Lifestyle modifications can help you cope with the daily challenges of living with chronic illness and its impact on your life.

We know that stress is an influential symptom trigger in both Migraine and MS, so one important thing we can do to try and prevent symptoms and keep our nervous system calm is to practice stress management strategies.

Actively working on improving mental and physical health through balanced nutrition, adequate restorative sleep, hydration, and exercise; while regularly practicing coping skills like meditation, mindfulness, and journaling, can help to strengthen the body and brain and build resilience.

These lifestyle modifications can help us to be better equipped to cope with the emotional impact of living with Migraine and MS and can improve life satisfaction and quality of life.

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