Is Lupus Headache really Lupus Headache?

Should certain types of headache be considered evidence of lupus (systemic lupus erythematosus (S.L.E.))?  It’s an ongoing debate, but new research suggests even more strongly that there is not a strong, obvious link between lupus and headache.

Quite a while ago, Dr. Marc Gotkine wrote a guest article regarding lupus headache, in which he confirmed that in most cases headache was not directly linked to lupus.

Last month, reports on a new study out of Canada confirmed the same thing.  1732 lupus patients were recruited for the study, and each patient was regularly assessed.

Now the results are a little tricky, so give me a moment to explain.  There is currently a definition of “Lupus Headache” that is used in the assessment of lupus:  Severe persistent headache: may be migrainous, but must be nonresponsive to narcotic analgesia.  (See the Systemic Lupus Erythematosus Disease Activity Index)

The research found that only 2% of lupus patients reported such a headache.

So the researchers are suggesting that lupus headache is so rare that it’s not really a useful indicator.

So why has lupus headache been such a big deal in the past?  The lead author of the study, Dr. John Hanly, explains:

There is conflicting evidence that links headache, including migraine, and lupus disease activity.  Much of the discrepancy in previous studies may be due the lack of uniform definition of headache, which is a common occurrence in the general population, especially among women.

In other words, we’re mistaking other kinds of headache for “lupus headache”.

In fact, the study showed that headache was quite common among lupus patients.  The point is not that there is no connection whatsoever.  The question is – is headache a result of lupus?  Is it a useful indicator of lupus?

In most cases, the headaches are actually migraine headaches or tension-type headaches.  Lupus treatment didn’t help – but treatment of the headache condition may help.

This study is important as we continue to learn about lupus, and as we help patients who struggle with both lupus and headache.  A better understanding will help us better treat both.

If you’re a lupus patient, your best bet may be to see your headache as a separate condition, and get proper treatment for your type of headache from a doctor who knows your medical history.

For more information:

• Headaches in Lupus Patients Not Linked to Disease Activity Study Says (Arthritis & Rheumatism)
• Headaches in Lupus Patients Not Linked to Disease Activity (ScienceDaily)