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Stabbing Headache – Could it be MS?

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Although most autoimmune disorders are chronic, patients have a number of reasons for wanting to diagnose them early.  First and most importantly, there is the concern that these disorders are degenerative – they get worse as time goes by, in a way which may not be reversible.

Of course there’s also the matter of the symptoms themselves.  The sooner you can get them under control, the sooner the patient can have a life with less disability.

And this is what makes some recent research into primary stabbing headache particularly interesting.

Stabbing headache is characterized as jolts of headache pain (often in the face or around they eye) that usually last for two or three seconds.  It may just happen once, or it could happen many times a day.

Many migraine patients have the occasional stabbing headache.  Treatment often involves a non-steroidal anti-inflammatory drug, such as indomethacin.

Primary stabbing headache is not caused by a known underlying disorder (by definition).  However, a study published in 2012 following 26 patients with stabbing headache found that over half of the patients also had an autoimmune disorder (Stabbing headache in patients with autoimmune disorders.).

This would include not only multiple sclerosis but also lupus, autoimmune vasculitis, and Sjogren’s syndrome.

Could the damage done by these diseases actually bring on the stabbing pain?

A more recent study found that a flare-up of multiple sclerosis (MS) could bring on the stabbing pain, and that treating the MS would also alleviate the head pain (Stabbing headache as a sign of relapses in multiple sclerosis.).

Could this type of pain be an early sign of an autoimmune disease?  At the very least, it could be a sign that a flare-up needs to be treated.  If doctors are aware of the connection between stabbing headache and autoimmune disorders, they may be able to ask the right questions to get patients treatment faster.

Is it Migraine or Lupus?

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Are all those symptoms you’re having a result of migraine?  Or could it actually be lupus?

Lupus is defined by the Mayo Clinic in this way:

Lupus is a chronic inflammatory disease that occurs when your body’s immune system attacks your own tissues and organs. Inflammation caused by lupus can affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart and lungs.

There are a couple of major challenges here.  Like migraine, lupus can result in a very different variety of symptoms depending on the person.  Also like migraine, lupus symptoms may come and go.

Lupus - confused with migraine?

Don’t get me wrong – for a specialist, there are certain profiles that will obviously point in one direction or another.  But that’s not always the case.

Another challenge is that a high percentage of lupus patients have migraine as well, or another type of headache.  As we know, migraine can go along with a whole host of other issues, including stiffness, irritable bowel syndrome, and gastrointestinal problems.  When you’re dealing with a host of aches and pains, it can be hard to know where they’re all coming from.

In a recent report in the journal Current Neurology and Neuroscience Reports, Dr. Sean Ruland and his colleagues expressed concern that lupus treatment is often delayed because doctors seeing headaches or seizures are missing the proper diagnosis.

To make matters worse, some of the common treatments for lupus may cause neurological side effects.

Glori Davis wrote in Migraine Mystery Turns Out to be Autoimmune Disease about her struggles to get a proper diagnosis.  Struggling with migraine and other symptoms, she finally saw a rheumatologist and was diagnosed with systemic lupus erythematosus (SLE).

Again, the fact that lupus patients may have migraine doesn’t mean they have only lupus and not migraine – more likely they have both, meaning that both require special treatment.

How can a patient work to get a proper diagnosis?  One of the most important things is to keep track of those strange, on-again-off-again symptoms that you have.  Don’t just assume that “you’re getting old” or “you’re stressed”.  Those kinds of answers mask the real problem.

Instead, be aware of things like:

  • Pain:  Where is it?  When?  What kind of pain?  How often?
  • Abdominal problems:  Stomach pain, digestive problems, nausea
  • Joints:  Pain?  Stiffness?
  • Skin:  Rashes?  Lesions?  Colour changes in fingers and toes?
  • Fatigue?  Fever?  Feeling down or depressed?  Confusion or paranoia?  Seizures?

Many of these symptoms are common in both migraine and lupus.  Skin issues can be a tell-tale sign of lupus, as are certain types of pain.

Doctors and specialists need to be aware of the overlap of symptoms between many neurological diseases such as migraine and lupus.

If you’re a patient and you suspect lupus, you may want to see a rheumatologist.  For more information, here are some sites you can check out:

Is Lupus Headache really Lupus Headache?

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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:

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