Reference Work Entry

Handbook of Headache

pp 137-153

Comorbidities of Headache Disorders

  • Markus SchürksAffiliated withDivision of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical SchoolDepartment of Neurology, University Hospital Essen Email author 
  • , Dawn C. BuseAffiliated withDepartment of Neurology, Albert Einstein College of Medicine of Yeshiva UniversityFerkauf Graduate School of Psychology of Yeshiva University, Montefiore Headache Center
  • , Shuu-Jiun WangAffiliated withDepartment of Neurology, Neurological Institute, Taipei Veterans General HospitalDepartment of Neurology, National Yang-Ming University School of Medicine

Abstract

Headaches are common disorders and migraine is most intensively investigated due to its high prevalence and often highly disabling character. Many conditions that are likewise prevalent have been described comorbid with migraine, and an increase of many comorbid conditions is seen among those with migraine with aura and higher frequency of headache. Well-established comorbidities include cardiovascular, psychiatric, neurological, and other pain disorders. With regard to cardiovascular disorders an association between migraine with aura and ischemic stroke has been most consistently described. Migraine with aura confers a twofold increased risk. Younger age, female gender, smoking, and oral contraceptive use seem to further raise the risk among migraineurs. With regard to psychiatric disorders, those with migraine are at increased risk of major depression, anxiety, panic disorder, bipolar disorder, abuse and neglect, and suicidal ideation or attempts. Common neurologic comorbidities include epilepsy and restless leg syndrome. Potential explanations for increased comorbidities will be explored. The complex network of an association between migraine and many other comorbid conditions is likely due to shared genetic factors that are further modified by environmental factors.