Eidlitz-Markus Tal, Zeharia Avraham
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.
J Headache Pain. 2017 Aug 8;18(1):80. doi: 10.1186/s10194-017-0789-z.
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.
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.
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).
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.
关于儿科患者临床偏头痛参数性别差异的现有数据基于相对较少的研究，这些研究未采用国际头痛协会当前版本的《国际头痛疾病分类》（ICHD）。本研究的目的是比较根据ICD - III - beta版本诊断为偏头痛的儿童和青少年男性与女性之间的人口统计学和临床特征。
在一家三级儿科头痛诊所的电子数据库中搜索2010 - 2016年期间所有诊断为偏头痛的儿童和青少年。从病历中收集人口统计学、症状和头痛相关参数的数据。按性别比较结果。
该队列包括468名儿童和青少年，平均年龄11.3±3.6岁；215名男性（45.9%）和253名女性（54.1%）。313例患者（66.9%）记录为无先兆偏头痛，127例（27.1%）为有先兆偏头痛；28例患者（6.0%）可能患有偏头痛。以下参数女性患者的值显著高于男性患者：入院年龄（p = 0.042，科恩d值0.8303，95%置信区间0.614 - 0.992）；偏头痛发作年龄（p = 0.021，科恩d值0.211，95%置信区间0.029 - 0.394）；有先兆偏头痛的发生率（比值比2.01，95%置信区间1.29 - 3.16，p = 0.0056）；头痛频率（p = 0.0149，科恩d值0.211，95%置信区间0.029 - 0.3940）；慢性偏头痛的发生率（p = 0.036，比值比1.54，95%置信区间1.02 - 2.34）；以及青春期（比值比3.51，95%置信区间2.01 - 6.35，p = <0.001）。男性呕吐发生率较高（比值比0.62，95%置信区间0.41 - 0.93，p = 0.018）。按青春期阶段进一步分析显示，青春期女性而非青春期前女性有先兆偏头痛的发生率显著高于男性（41.1%对28.9%；比值比1.42，95%置信区间0.85 - 2.37，p = 0.039）。
在三级儿科头痛诊所接受治疗的偏头痛女童和青少年的特点是慢性偏头痛和有先兆偏头痛的发生率较高，呕吐发生率较低，且发病年龄比男性大。这些发现可能受到女性因其更好的语言能力而对偏头痛症状描述更准确的影响。
