xRead - Olfactory Disorders (September 2023)

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1610

November/December 2016

Olfactory symptoms

a. Do you feel any odor that does not exist right before the beginning of your headache crisis? (OLFACTORY HALLUCINATION)

1 – YES

2 – NO

1

b. Which one? (subjective question)

A:

a. Do you have hypersensitivity to any odor in the period between the crisis?(IOH)

1 – YES

2 – NO

2

b. Which one? (subjective question)

A:

3 a. Do you have any odor aversion during the headache crisis? In other words, headache worsens when you feel that odor? (OSMOPHOBIA)

1 – YES

2 – NO

b. Which one? (subjective question)

A:

a. Is there any odor which can start your migraine attack? (ODOR TRIGGER)

1 – YES

2 – NO

4

b. Which one? (subjective question)

A:

Fig. 1.—Main questions of olfactory symptoms questionnaire regarding olfactory hallucination, interictal olfactory hypersensi tivity, osmophobia, and odor triggers.

and interictal hypersensitivity, as well as to the nature of odors that trigger the migraine. A list of presumed triggering odors was provided in the ques tionnaire to help the patient to identify which, if any, may be involved. The main questions are repre sented in Figure 1. Phantosmia was considered a sensation of an odor or odors in the absence of a stimulus not directly related to headache onset (ie, odor percep tion without a subsequent headache). In contrast, an olfactory hallucination was characterized as the perception of an odor 5–60 minutes before head ache onset (ie, as a kind of aura phenomenon). The perception of an unpleasant fecal-like odor differ ent from normal was considered cacosmia and euosmia was defined as a pleasurable distortion of a real odorous stimulation (eg, like a perfume). The patient assessed his or her olfactory ability during the interictal period using a visual analog scale (VAS) with 0% defining one extreme of absence of olfactory sensation and 100% defining the other extreme of having normal olfactory function. Based on these responses, four categories of olfactory func tion were formed: (1) 0–25%; (2) 26–50%; (3) 51– 75%; and (4) 76–100%. The VAS method has been shown to correlate moderately with psychophysical

routine visits of medical primary care and volun teers, in the period from January to August 2014, who met the ICHD-II criteria for episodic migraine 29 (27 men and 86 women; respective mean (SD) ages 5 28.7 ( 6 8.2) and 34.3 [ 6 11.8]). The sample size was based on previous experience and other studies. Exclusion criteria included a previous history of olfactory disorders due to neuropsychiat ric disease (except depression), head trauma, rhino sinusitis diagnosed by a physician, and neurological disease (eg, Parkinson’s, Alzheimer’s, epilepsy, stroke, brain tumors, and palsy of arms or legs). No physical examination was performed. All patients provided written informed consent and the study was approved by the local ethics committee of State University of Londrina, no 402.435. There was no external funding source. Questionnaire for Quantitative and Qualitative Olfactory Assessment.— A team of five trained research specialists administered a 65-item question naire to the subjects. This questionnaire contained specific olfaction-related questions designed to char acterize the olfactory symptoms of migraineurs with and without auras. Included were questions related to phantosmia, olfactory hallucinations, cacosmia/ euosmia, self-related olfactory ability, osmophobia,