RES E A R C H A R T I C L E Open Access
Symptoms and clinical parameters of
pediatric and adolescent migraine, by
gender - a retrospective cohort study
and Avraham Zeharia
Background: The available data on gender differences in clinical migraine parameters among pediatric patients are
based on relatively few studies, which did not use the current version of the International Classification of Headache
Disorders (ICHD) of the International Headache Society. The aim of the present study was to compare between males
and females, demographic and clinical characteristics of children and adolescents with migraines diagnosed according
to the ICDIII-beta version.
Methods: The electronic database of a tertiary pediatric headache clinic was searched for all children and adolescents
diagnosed with migraine headaches in 2010–2016. Data on demographics, symptoms, and headache-related parameters
were collected from the medical files. Findings were compared by gender.
Results: The cohort included 468 children and adolescents of mean age 11.3 ± 3.6 years; 215 males (45.9%) and 253
females (54.1%). Migraine without aura was documented in 313 patients (66.9%), and migraine with aura in 127 (27.1%);
28 patients (6.0%) had probable migraines. The female patients had significantly higher values than the male patients for
the following parameters: age at admission (p = 0.042, Cohen’s d 0.8303, 95% CI 0.614–0.992); age at migraine onset
(p = 0.021, Cohen’s d 0.211, 95% CI 0.029–0.394); rate of migraine with aura (OR 2.01, 95% CI 1.29–3.16, p = 0.0056);
headache frequency (p = 0.0149, Cohen’s d 0.211, 95% CI 0.029–0.3940); rate of chronic migraine (p = 0.036, OR 1.54,
95% CI 1.02–2.34); and puberty (OR 3.51, 95% CI 2.01–6.35, p = <0.001). Males had a higher rate of vomiting (OR 0.62,
95% CI 0.41–0.93, p = 0.018). Further analysis by pubertal stage revealed that pubertal females, but not prepubertal
females, had a significantly higher rate of migraine with aura than did males (41.1% versus 28.9%; OR 1.42, 95% CI 0.85–2.
37, p = 0.039).
Conclusion: Female children and adolescents with migraine treated in a tertiary pediatric headache clinic were
characterized by a higher rate of chronic migraine and migraine with aura, a lower rate of vomiting, and older age at
onset relative to males. These findings might be influenced by the better description of migraine symptoms by females
owing to their better verbal ability.
Keywords: Female, Males, Migraine, Pediatric, Adolescent, Chronic migraine, Age onset, Migraine with aura, Puberty
* Correspondence: email@example.com
Pediatric Headache Clinic, Day Hospitalization Department, Schneider
Children’s Medical Center of Israel, Petach Tikva, Israel
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
The Journal of Headache
© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made.
Eidlitz-Markus and Zeharia The Journal of Headache and Pain (2017) 18:80