As if essential tremor (ET) isn’t enough trouble, some studies have found that those with ET have a greater risk of migraine headaches.
Migraines
If you have ever had a headache – and most people have at one time or another – you know how much head pain can make an ordinary day seem like slogging through a swamp. Headaches can occur for a variety of reasons: tension, sinus problems, triggering foods or alcohol, exertion, fatigue, etc. Many headaches respond to over-the-counter pain relief products. Migraines, however, are a separate condition.
It used to be thought that migraine pain was the result of blood vessels in the brain either dilating (widening) or constricting (narrowing). Now those theories have given way to new scientific evidence that migraines are a neurological disorder (just as ET is) in which nerve pathways and brain chemicals are involved. The Migraine Research Foundation describes migraine as “an extremely incapacitating collection of neurological symptoms that usually includes a severe throbbing recurring pain on one side of the head. However, in 1/3 of migraine attacks, both sides are affected. Attacks last between 4 and 72 hours and are often accompanied by one or more of the following disabling symptoms: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face.”
A link between ET and migraines?
Some studies have suggested there is an association between ET and migraine headaches, though the data is not consistent. Therefore, debate has been ongoing since the 1990s. One of the earliest studies in 1990 found that just over a third of 74 ET patients (36.5%) suffered migraines compared with 17.7% of 102 non-ET controls.i When they came at it a different way, they discovered that out of 58 migraine patients, 17.2% had ET vs. only 1.2% of non-migraine patients. This study concluded that a link may exist between ET and migraines.
Twenty years later, in 2010, Barbanti et al. found no correlation between the two conditions based on 110 people with ET and 110 matched controls.ii
Then, in 2014 a research team conducted a similar case-matched study involving 150 people with ET and 150 matched controls. This time, the researchers found a 22% prevalence of migraines among those with ET vs. 12.7% among controls.iii They concluded that those with ET have a higher lifetime risk of migraines; they also found that ET patients with migraines tended to have a specific gene variant that ET patients with no migraines did not.
Yet, just one year later, a paper was published based on a literature review of 79 earlier studies of migraines and other types of headaches in association with tremor.iv After analyzing all articles, the authors found no clear correlation between ET and migraines or other types of headache. They report, “Many conditions may feature both headache and tremor, but rarely as core clinical symptoms at presentation.”
These four papers – 2 reporting a link and 2 reporting no clear link – are representative of the controversy over ET correlated with migraines. The issue is not resolved, nor is it likely to be in the near future.
Migraines are a misery for those who experience them. It must be a “double whammy” for individuals who have both ET and migraines, particularly if their tremors are unable to be controlled using medications. The team at Sperling Neurosurgery Associates offers MRI-guided Focused Ultrasound (MRgFUS) for durable tremor control following a noninvasive outpatient procedure. Learn more or contact us through our website.
iBiary N, Koller W, Langenberg P. Correlation between essential tremor and migraine headache. J Neurol Neurosurg Psychiatry. 1990;53(12):1060-1062.
iiBarbanti P, Fabbrini G, Aurilia C, et al. No association between essential tremor and migraine: A case-control study. Cephalalgia. 2010;30(6):686-689.
iiiHu Y, Tang W, Liu R, Dong Z et al. Higher prevalence of migraine in essential tremor: a case-control study. Cephalalgia. 2014 Dec;34(14):1142-9.
ivKuiper M, Hendrikx S, Koehler P. Headache and tremor: co-occurrences and possible associations. Tremor Other Hyperkinet Mov (N Y). 2015; 5: 285.
About Dr. Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Neurosurgery Associates.