Osmophobia in Juvenile Primary Headaches

Abstract

This study was planned to investigate the prevalence of osmophobia in juvenile headache sufferers and to analyse the diagnostic utility of osmophobia in order to distinguish migraine without aura from episodic tension-type headache. We examined 305 consecutive patients presenting at our Paediatric Headache Centre. A semistructured questionnaire was given to 275 selected patients affected by migraine or tension-type headache. The prevalence of osmophobia during attacks was 18.5%, mainly in migraine patients (25.1%) vs. those with tension-type headache (8.3%). Osmophobia showed more specificity than phonophobia or photophobia in the differential diagnosis between migraine and tension-type headache. In conclusion, this study demonstrates that osmophobia resulted in a symptom with poor sensitivity (27.1%) but high specificity (92%) that could become a supportive diagnostic criterion even in children for the differential diagnosis between migraine without aura and tension-type headache.

Phenytoin in the Treatment of Osmophobia in Migraine Patient: A Case Report

“…Although osmophobia is not a diagnostic criterion for migraine, many studies show that this symptom is highly prevalent and is useful to differentiate migraine from tension-type headache [1,4,5,7,8,13]. Such as headache, osmophobia affects the quality of life of migraine patients and hinders the performance of their professional activities, especially in those who work in environments with strong odors, such as in perfumery, gas station and the selling of insecticide or beauty products [10,11].…”

“…There is a significant association between odors and primary headaches, particularly to migraine with or without aura [1][2][3][4][5][6] and tension-type headache [1,[6][7][8]. The literature of its occurrence in secondary headaches is very scarce [9].…”

“…In migraine patients, prevalence of osmophobia during the headache attacks ranges from 20.0% to 81.7% [1,3,5,6,8,13] and in the period between headache attacks, this prevalence ranges from 24.0% to 53.3% [1,3,11,12]. Several categories of drugs are used in migraine prophylaxis, such as beta-adrenergic blockers, tricyclic antidepressants, calcium channel blockers, serotonergic antagonist, antiepileptics, and others [14][15][16].…”

Osmophobia and Odour-triggered Headaches – Review of the Literature and Main Research Centres

“…Generally, we observed a severe intolerance to odours, pleasant or unpleasant, during headache attacks. 2,[4][5][6][7][8]10,11,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] However, a limited number of studies showed that odours may trigger headache attacks in some patients, particularly in migraineurs 1,3,6,7,9,24 and occasionally in cluster headache patients. 12,18 This intolerance to odours is known as osmophobia, and according to two studies that investigated osmophobia in secondary headaches, it occurred during headache attacks only in the primary headaches.…”

“…2 Many researchers have confirmed that osmophobia is a symptom associated with migraine. 2,[4][5][6][7][8]10,11,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Despite such research, osmophobia is still not part of the diagnostic criteria for migraine. 34 In recent years, these studies were carried out in several countries.…”