Osmophobia in Migraine and Tension-Type Headache and Its Clinical Features in Patients With Migraine

Abstract

Intolerance to smell is often reported by migraine patients. This study evaluates osmophobia in connection with the diagnosis of migraine and episodic tension-type headache (ETTH). The characteristics of this symptom are also investigated. We recruited from our Headache Centre 1005 patients (772 female, 233 male; age 37 +/- 11 years), of whom 677 were migraine without aura (MoA), 130 migraine with aura (MA) and 198 TTH. Patients with two or more forms of primary headache were excluded. Among migraine patients, 43.9% with MoA and 38.5% with MA reported osmophobia during the attacks; none of the 198 TTH patients suffered this symptom. Most frequently offending odours were scents (63.9%), food (55.2%) and cigarette smoke (54.8%). Osmophobia appears structurally integrated into the migraine history of the patient. It seems to be a peculiar symptom favouring the diagnosis of migraine (MoA and MA) in the differential diagnosis with ETTH.

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

“…The majority of studies investigated the presence of osmophobia. There were 13 comparative studies between migraine and other primary headaches or controls without headache, 2,3,5,8,13,14,[17][18][19][20]22,28,31 and 10 that evaluated only migraine patients. 4,6,7,11,15,16,24,26,29,30 As for odour-triggered headache, there were six studies detected, two comparative studies between migraine and other primary headaches, 1,3 two with migraine patients, 7,24 and two case reports.…”

“…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.…”

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].…”