目的探讨原发性头痛与多发性硬化(MS)间的关系。方法选择171例MS患者,其中头痛组51例,非头痛组120例,分析头痛组原发性头痛的特征及不同类型头痛的发病情况。对比头痛组和非头痛组的病程、发病类型、影像学及相关疾病的发病情况。结果 29.8%的MS患者伴有原发性头痛,2/3患者头痛早于MS症状,头痛以颞侧、枕部好发,搏动性、紧缩性痛常见,持续4 h以上,发作较频繁,多为中、重度疼痛。多有3处以上(90.2%)的发病部位,脑干、丘脑、胼胝体处的病灶明显多于非头痛组。偏头痛(47.1%)最常见,以年轻的复发缓解型多发性硬化(R-R MS)多见。继发进展型多发性硬化(SP MS)好发紧张型头痛,年龄较偏头痛患者更大(P<0.05)。头痛组患者较非头痛组患者更易合并脑梗死(P<0.05)。结论近1/3的MS患者伴有原发性头痛,年轻患者多见,病灶较多,脑干为主,疼痛较严重,偏头痛最常见。 Objective To explore the relationship between primary headache and multiple sclerosis (MS). Methods 171 patients with MS were selected, including 51 cases of headache group and 120 cases of non-headache group. The characteristics of headache in headache group and the incidence of different types of headache were analyzed. The duration of headache group and non-headache group, the type of disease, imaging and the incidence of related diseases were compared. Results 29.8% of MS patients had primary headache, two thirds of patients had headache earlier than MS symptoms, headache with temporal and occipital onset, pulsatile and tightening pain were common, lasting more than 4 hours with more frequent seizures, Mostly, severe pain. More than three (90.2%) of the incidence of parts, brainstem, thalamus, corpus callosum lesions were significantly more than non-headache group. Migraine (47.1%) was most common and was more common in younger relapsing-remitting multiple sclerosis (R-R MS). Secondary progressive multiple sclerosis (SP MS) developed tension-type headache, older patients with migraine (P <0.05). Patients in the headache group were more likely to have cerebral infarction than those in the non-headache group (P <0.05). Conclusion Nearly one-third of MS patients with primary headache are more common in younger patients with more lesions, mainly in brain stem, more severe pain and migraine.