Sensitivity to Various Stimuli in Primary Headaches: A Questionnaire Study

Abstract

Questions about discomfort or pain produced by various stimuli (e.g., light, sound, exercise, neck movements) are currently used to differentiate between various primary headache disorders. In order to evaluate the usefulness of differences in sensitivity to physical stimuli in headache diagnosis, the answers to a questionnaire about sensitivity to various stimuli were compared in 68 patients with migraine, 45 with tension-type headache, 46 with cluster headache, and 23 patients with cervicogenic headache, and in 71 controls. Even among controls, a high proportion reported that many of these stimuli could elicit some degree of discomfort or pain. Without headache, migraineurs differed from the other patients with headache and controls mainly in their increased sensitivity to light. With headache, patients with tension-type headache were the least sensitive and migraineurs were the most sensitive to all stimuli, except for stimuli stemming from neck movements, to which patients with cervicogenic headache were most sensitive. Migraineurs also reported the highest degree of sensitivity regarding aggravation and provocation of headache. However, the most striking finding was that all patient groups, cluster headache in particular, became significantly more sensitive with headache than without headache to almost all stimulus categories. This may indicate that these headaches share important pathogenetic mechanisms. The fact that no headache had a very specific sensitivity profile may point to weaknesses of present headache classification systems.

Migraine and Olfactory Stimuli

“…A Norwegian study compared hypersensitivity to odours during TTH and migraine. Thirteen % in TTH compared to 46% in migraine experienced osmophobia [26]. In an Italian study of 1,005 headache patients 297/677 43.9% of patients with MO and 50/130 38.5% of patients with MA reported osmophobia whereas none of the patients with tension-type headache (TTH) suffered from osmophobia during headache attacks [18].…”

“…Interictal Olfactory Hypersensitivity-OHS Olfactory hypersensitivity (OHS) has been observed between attacks in migraineurs [26]. Olfactory hypersensitivity is the subjective perception of distress upon exposure to odours in concentrations perceived in the vast majority of the population as neutral or pleasant and do not cause any distress.…”

Opioid resistance in chronic daily headache: A synthesis of ideas from the bench and bedside

“…Patients with CDH often are sensitive to many different sensory stimuli such as light, sound, smell, and touch [12]. Other symptoms include chronic nausea, diminished appetite, poor sleep, dizziness, disequilibrium, fatigue, cognitive inefficiency, and behavioral and mood changes.…”

“…Hyperalgesia and allodynia of the scalp, neck, and shoulder may be present [33••] and are consistent with an expansion of sensory receptive fields, which also is described in other neuropathic pain syndromes. Patients frequently report sensitivity to sensory stimuli that are not typically painful or unpleasant, such as light, sound, and olfactory scents [12].…”

Evaluation of the Frequency and Intensity of Osmophobia Between Headache Attacks in Migraine Patients Through an Osmophobia Diary

“…Osmophobia is defined as intolerance to odors and it is associated to primary headaches, particularly to migraine with or without aura [1,[2][3][4][5][6][7] and it may be present in tension-type headache [5,[8][9][10][11]. The literature of its occurrence in secondary headaches is very scarce [12].…”