xRead - Olfactory Disorders (September 2023)

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Headache

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Table 1.—Demographics of the Study Group, Clinical Features of migraine, and Comparison of Olfactory Symptoms Between MA (Migraine With Aura) and MwA (Migraine Without Aura)

Group Without Aura, N (%) (n 5 56)

Group withAura, N (%) (n 5 57)

NTotal (%) (n 5 113)

Variable

Category

P -Value

Gender

Men

27 (23) 86 (77)

13 (48) 43 (76)

14 (51) 43 (75)

.87

Women

Age (years 6 SD)

32.5 6 11.0

33.4 6 11.7

.7

Nausea

104 (92) 105 (93)

50 (89) 53 (94)

54 (94) 52 (91) 52 (91) 40 (70) 54 (94) 51 (89) 8 (14)

.32

Photophobia/phonophobia

.7

Visual aura

Sensitive aura Osmophobia

108 (95) 102 (90) 16 (14)

54 (96) 51 (91) 8 (14)

.5 .7

Crisis triggered by odors

Interictal olfactory hypersensitivity

1.0

Olfactory hallucination

7 (6) 5 (4) 3 (2)

2 (3) 2 (3) 2 (3)

5 (8) 3 (5) 1 (1)

.4

Phantosmia

1.0

Cacosmia/euosmia

.6

Chi-square, Fisher’s exact, and Student’s t -tests used.

olfactory tests. 30,31 The determination of osmophobia was based on the question, “Do you have any odor aversion during the headache crisis?” IOH was addressed by the question, “Do you have hypersen sitivity to any odor in the period between crisis?” Statistical Analysis.— Stata 10.1 software was used for all statistical analysis. Continuous varia bles, such as age, number of crisis per year, rated olfactory acuity, and total numbers of olfactory symptoms, were expressed as means 6 standard deviations (SD). t -tests were used to compare the means of the migraineurs with and without auras. Categorical variables such as olfactory symptoms (osmophobia, IOH, phantosmia, olfactory hallucina tion, cacosmia/euosmia, groups of self-reported olfactory acuity, and olfactory triggers of the crisis), types of triggers, nausea, and photo/phonophobia were expressed in percentages and their frequencies compared using chi-square analyses, and Fisher’s exact test was applied when needed. A two tailed P value was used, and the cutoff statistical signifi cance was P < .05. RESULTS The demographics and presence of the sensory phenomena for the migraineurs with and without

aura are presented in Table 1. Age and gender did not differ significantly between the two groups. Visual aura was the most prevalent type of aura, present in 91% of the MA (migraine with aura) patients. Osmophobia was the main olfactory symptom, being reported by 95% of all migraineurs. No sta tistical significant difference in the frequency of osmophobia was found between patients with and without auras (Table 1). Those experiencing this symptom reported it to be present in 88% of the headache crisis they experienced. Osmophobia commonly followed odor-triggered crisis (90%). This was not the case for IOH (14%), olfactory hal lucinations (6%), phantosmia (4%), and cacosmia/ euosmia experiences (2%). Olfactory symptoms did not differ among men and women. Moreover, self reported olfactory acuity, as measured by the VAS, was similar in patients with and without auras. The number and type of total olfactory symptoms also did not differ between these two groups ( P > .05). Interestingly, 73% of patients who experienced osmophobia and 75% of those odor triggered head aches reported having 51–75% (group 3) of olfactory acuity according to their VAS ratings, representing therefore most cases, leaving only 27% and 25%,