The Association Between Allergic Disorders and Migraine in the Pediatric Population: A Nationwide Cohort Study

Migraine is a relatively common neurologic disorder among children. A possible association between migraine and allergic diseases in the pediatric population has been suggested. This study aimed to explore the prevalence and distribution of allergic disorders among children with migraine.

We conducted a nationwide retrospective cohort study using electronic medical record data from Clalit Health Services, Israel. Children aged 5-18 years who were diagnosed with migraine between January 1, 2000, and June 30, 2023, were included. Demographic characteristics and allergic comorbidities, including asthma, allergic rhinitis, allergic conjunctivitis, atopic dermatitis, and food allergy, were analyzed and compared in patients with migraine, stratified by the presence or absence of concomitant allergic disease.

A total of 51,411 children with migraine were included, of whom 16,658 (32.4%) had at least one allergic disease and 34,753 (67.6%) had no allergic comorbidity. Children with allergic disease were older at presentation than those without allergic disease (median age 15 [interquartile range 11-16] vs 13 [interquartile range 10-15] years; P < 0.001). Allergic conjunctivitis and allergic rhinitis were the most common allergic disorders. Significant differences were observed across age groups, sectors, socioeconomic statuses, and sex-specific distributions of allergic phenotypes.

Allergic comorbidity is common among children with migraine, with allergic conjunctivitis and allergic rhinitis representing the most frequent associated conditions. These findings underscore the need for heightened clinical attention to co-occurring allergic disease in pediatric patients with migraine. They further indicate that an integrated neurologic-allergic evaluation may improve clinical management in this population.