Osmophobia and Headaches in Primary Care: Prevalence, Associated Factors, and Importance in Diagnosing Migraine

Abstract

We found high prevalence of osmophobia among migraine patients, and this complaint is useful in making the diagnosis of migraine in primary care. Osmophobia is associated with migraine and more years of headache history.

Olfactory symptoms reported by migraineurs with and without auras

“…It is now well established that odors in particular trigger and aggravate the crisis (osmophobia) . There is some evidence that the presence of osmophobia may be useful in differentiating migraine without auras from episodic tension type headache, although the sensitivity of such differentiation ranges from 23% to 86% and specificity 69% to 94% . One longitudinal prospective study found osmophobia to be an important predictor of migraine development in children initially classified as having tension type headache .…”

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.…”

“…In addition, the five authors who have published most of these studies were born in these three countries. [1][2][3][4][5]7,8,14,15,[18][19][20] We do not have a scientific argument for this fact, but curiously these three countries were pioneers in the study of migraine.…”

“…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.…”