Evaluation of migraine characteristics by gender in relapsing-remitting multiple sclerosis

The aim of this study is to comparatively evaluate the clinical characteristics of migraine, accompanying symptoms, migraine-related disability level, and its impact on quality of life according to sex in individuals diagnosed with Multiple Sclerosis (MS). A total of 511 MS patients who presented to the Neurology MS outpatient clinic over the course of one year were included in the study and screened for headache. Among them, 200 MS patients with migraine and 200 migraine patients without comorbidities as a control group were enrolled. Headache type, accompanying symptoms, attack frequency, use of analgesic and prophylactic medications were assessed; disability level was measured with the MIDAS questionnaire, headache impact with HIT-6, and overall quality of life with the SF-36 questionnaire. Data were analyzed by sex. The prevalence of headache in MS patients was found to be 66.3%, with migraine being the most common type (40.5%). Migraine was more prevalent in female MS patients compared to males (p<0.001); however, symptoms such as aura and nausea-vomiting were reported less frequently in male patients. HIT-6 and MIDAS scores were higher in male MS patients with migraine compared to females, suggesting a higher individual burden of migraine in men. Male migraine patients were found to use healthcare services and analgesics less frequently. The clinical course of migraine in MS patients differs by sex. Although migraine is less common among male MS patients, its impact on disability and quality of life appears to be greater. These findings highlight the necessity of a sex-sensitive clinical approach and the importance of considering sex differences in the diagnosis and treatment of migraine in MS patients.