Migraine and Olfactory Stimuli

Abstract

Migraine patients often report intolerance to odours. Migraineurs report odours may trigger attacks, that they experience osmophobia during attacks, and olfactory hypersensitivity between attacks. In this paper we discuss olfactory mechanisms in migraine. We also present data from a pilot questionnaire study in a group of young women diagnosed with migraine. The study results confirm that hypersensitivity to odour is a common feature in women with migraine. Migraine pathophysiology likely explains this particular vulnerability. We discuss these pathophysiologic mechanisms and hypotheses relating odour intolerances and migraine.

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

“…We hypothesize that odorant substances bind to olfactory receptors and activate adenylate cyclase, leading to cyclic adenosine monophosphate (cAMP), which binds to sodium channels, triggering an action potential which propagates to the olfactory bulb [27]. These electrical impulses are directed to the primary olfactory cortex, where discrimination of odor happens [3,10]. Therefore, the action potential is not spread when the sodium channels are blocked by phenytoin and osmophobia is relieved.…”

“…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].…”

“…The literature of its occurrence in secondary headaches is very scarce [9]. They are triggers of headache attacks [2,10] or intolerance factor (osmophobia) [1] both during and between headache attacks (pain-free period) [1,3,11,12].…”

“…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.…”