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- Title
A prospective study on osmophobia in migraine versus tension-type headache in a large series of attacks.
- Authors
Terrin, Alberto; Mainardi, Federico; Lisotto, Carlo; Mampreso, Edoardo; Fuccaro, Matteo; Maggioni, Ferdinando; Zanchin, Giorgio
- Abstract
<bold>Background: </bold>In literature, osmophobia is reported as a specific migrainous symptom with a prevalence of up to 95%. Despite the International Classification of Headache Disorders 2nd edition proposal of including osmophobia among accompanying symptoms, it was no longer mentioned in the ICHD 3rd edition.<bold>Methods: </bold>We conducted a prospective study on 193 patients suffering from migraine without aura, migraine with aura, episodic tension-type headache or a combination of these. After a retrospective interview, each patient was asked to describe in detail osmophobia, when present, in the following four headache attacks.<bold>Results: </bold>In all, 45.7% of migraine without aura attacks were associated with osmophobia, 67.2% of migraineurs reported osmophobia in at least a quarter of the attacks. No episodic tension-type headache attack was associated with osmophobia. It was associated with photophobia or phonophobia in 4.3% of migraine without aura attacks, and it was the only accompanying symptom in 4.7% of migraine without aura attacks. The inclusion of osmophobia in the ICHD-3 diagnostic criteria would enable a 9.0% increased diagnostic sensitivity.<bold>Conclusion: </bold>Osmophobia is a specific clinical marker of migraine, easy to ascertain and able to disentangle the sometimes challenging differential diagnosis between migraine without aura and episodic tension-type headache. We recommend its inclusion among the diagnostic criteria for migraine as it increases sensitivity, showing absolute specificity.
- Subjects
MIGRAINE; MIGRAINE aura; HEADACHE; LONGITUDINAL method; BIOMARKERS
- Publication
Cephalalgia, 2020, Vol 40, Issue 4, p337
- ISSN
0333-1024
- Publication type
journal article
- DOI
10.1177/0333102419877661