Lupus and Headaches

There's good news for lupus patients who are plagued by headaches—the source of your pain is likely not the autoimmune disease, and you don't need to switch your treatment, according to new research.

A study in the latest issue of Arthritis & Rheumatism shows that although many lupus patients experience headaches—and they do impact their quality of life—they generally resolve over time without lupus-related therapies. The researchers did not find a link between headaches and specific lupus autoantibodies or lupus medications, such as steroids, antimalarials, and immunosuppressives.

The researchers say that nearly 60 percent of the lupus patients they studied experienced headaches within 10 years.  

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Pinpointing the Cause of Headaches in Lupus Patients

“When a lupus patient gets a headache, it’s very difficult to know whether that headache is due to lupus or not,” said study author Dr. John Hanly of Dalhousie University and the Queen Elizabeth II Health Sciences Centre in Canada.

His research found that a headache does not indicate that lupus is flaring up or that the patient needs to readjust his or her medication.

“It doesn’t mean that lupus is acting up,” Hanly said. “In the vast majority of patients, that’s not the case at all.”

Most of the headaches that occur in lupus patients are the same types that occur in the general population, Hanly noted, including migraines, tension headaches, and cluster headaches.

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A Comprehensive Look at Headache Activity

The study of 1,732 patients was conducted from October 1999 to September 2011. Patients had a mean age of 35 and were evaluated each year for headaches and other neuropsychiatric events. Almost 90 percent of patients were female.

The researchers found that 18 percent of patients experienced headache during the onset of the disease, which increased to 58 percent after a decade.

Of those who experienced headaches when the study began, 61 percent had migraines, 37 percent had tension headaches, seven percent had intractable non-specific headaches, three percent had cluster headaches, and one percent experienced intracranial hypertension headaches.

At the end of the study, only two percent of patients had reported experiencing a “lupus headache,” which is a severe headache that is clinically defined and does not respond to treatment.

Lupus patients who experience headaches probably do not have them more frequently than others without the disease in their age bracket, Hanly said. However, he said it's important not to dismiss the fact that headaches can have a negative impact on a patient’s quality of life.

Hanly said there are instances in which headaches can be tied to a nervous system event, but that the majority of headache cases in his study were not directly related to the disease.

Dr. Michael Lockshin of Weill Cornell Medical College and the Hospital for Special Surgery in New York said, “As a scientific study, it is far more cogent than prior studies and, in my opinion, definitive.”

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