Lupus and Headaches: Understanding the Connection
Headaches are a common symptom for people living with lupus, a chronic autoimmune condition that can affect multiple parts of the body, including the central nervous system. While headaches are not typically a direct cause of specific headache syndromes such as occipital neuralgia, they can be a significant part of the lupus experience for many patients.
Migraines and Lupus
Migraines are the primary type of headache experienced by many lupus patients, especially in juvenile lupus systemic erythematosus (jSLE), where headaches are common and linked to migraine pathology rather than lupus-specific inflammation alone.
Neuropsychiatric Lupus and Headaches
Neuropsychiatric lupus, which affects the brain and nervous system in 80-90% of lupus patients, can produce symptoms including headaches, depression, and cognitive dysfunction ("lupus fog"). This suggests that lupus-related immune activity in the nervous system and brain inflammation may contribute to headaches.
Occipital Neuralgia and Indirect Association
Occipital neuralgia, an inflammation or injury of nerves in the neck causing piercing headaches at the back of the scalp, can occur in lupus patients. However, lupus is not considered a direct cause. Instead, lupus may cause organ or tissue changes that indirectly contribute to occipital neuralgia or similar headache types.
Causes of Headaches in Lupus
The underlying causes of lupus involve autoimmune attacks on various tissues, including the nervous system, driven by genetic, environmental (infections, UV light), hormonal, and possibly toxic triggers. These factors may contribute to neurological symptoms such as headaches. Potential causes of headaches in people with lupus include aseptic meningitis, brain infections, brain tumors, a buildup of pressure in the brain, vascular diseases, and vasculitis.
Managing Headaches in Lupus
Over-the-counter and prescription medications can prevent and manage headaches, but people should check with their healthcare team first to ensure headache medications do not interact with any lupus treatments they are taking. Alternative methods for managing headaches may include meditation, acupuncture, cognitive and behavioral therapy (CBT), supplements or nutritional health products, and exercise, such as yoga.
Recognising and Addressing Urgent Symptoms
If a person with a headache experiences severe or worsening headaches, vomiting, a head injury, vision problems, changes in speech, difficulty swallowing, balancing, or walking, drowsiness or difficulty staying awake, they should seek urgent medical attention.
Preventing Headaches in Lupus
To reduce the chances of a lupus flare-up and prevent headaches, people should follow their treatment plan, get plenty of rest, treat symptoms as soon as they occur, stay hydrated, reduce exposure to stress, limit or avoid alcohol, limit screens and other causes of eyestrain, eat regular, healthy meals, and try to recognise and avoid potential triggers for headaches.
Seeking Medical Advice
If a person with lupus develops a persistent headache, they should contact a doctor as soon as possible for diagnosis and treatment. Lupus symptoms typically intensify during flare-ups, and taking steps to reduce the risk of a flare-up may help to prevent headaches.
In summary, headaches in lupus are often migraine-related or part of neuropsychiatric lupus syndrome, with additional types like occipital neuralgia being possible but indirectly associated. The exact mechanisms remain under investigation, but immune-driven nervous system inflammation and secondary effects are key contributors. It is crucial for people with lupus to manage their condition effectively to minimise the impact of headaches and other symptoms.
- Migraines are the primary type of headache experienced by many lupus patients, especially those with juvenile lupus systemic erythematosus (jSLE).
- Neuropsychiatric lupus, which affects the brain and nervous system in 80-90% of lupus patients, can produce symptoms including headaches, depression, and cognitive dysfunction.
- Occipital neuralgia, an inflammation or injury of nerves in the neck causing piercing headaches at the back of the scalp, can occur in lupus patients, but lupus is not considered a direct cause.
- The underlying causes of lupus involve autoimmune attacks on various tissues, including the nervous system, and these factors may contribute to neurological symptoms such as headaches, in addition to potential causes like aseptic meningitis, brain infections, and vascular diseases.
