Background: Despite being a frequent complaint among children and adolescents, there is still a considerable lack of comprehension regarding the distinctive characteristics of migraine in these age groups. One of these aspects is the influence of sex on the prevalence and characteristics of migraine.
Aim of the work: To evaluate the clinical characteristics of migraine headaches in children and adolescents in relation to sex of studied cases.
Patients and Methods: This Prospective Observational Study included 96 females and 82 males aged 6-18 years with migraine. Detailed history and physical examination were conducted. ICHD-3 criteria were used for diagnosis and migraine features were compared between sexes.
Results: Girls had a higher mean age than boys [12.5 ± 3.7 years vs. 11.4 ± 3.5 years, P = 0.044]. Males were more common in the <12 years age group, while females predominated in the 12-16 years group. Migraine onset was earlier in males [8.9 ± 2.7 vs. 9.4 ± 2.6 years; P = 0.21]. Girls experienced higher intensity migraines [P = 0.01]. Vomiting was significantly more prevalent in boys compared to girls [39% vs. 24%; P = 0.03]. Family history, migraine types and triggers did not differ.
Conclusion: This study demonstrated notable sex-based differences in the clinical profiles of pediatric migraine. Females tended to experience higher migraine severity and burden, while males presented with certain gastrointestinal symptoms more commonly. Earlier identification of distinct characteristics according to biological sex may assist clinicians in optimizing evaluation and management strategies tailored for individual patients. Further research should explore potential pathophysiological underpinnings driving these observed clinical disparities between boys and girls with migraine.