xRead - Olfactory Disorders (September 2023)

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November/December 2016

Table 2.—Relationship Between Interictal Olfactory Hypersensitivity (IOH) and Other Olfactory Symptoms

0 10 20 30 40 50 60 70 80 90 100

n total MwA MA

No IOH [n (%)] (n 5 97)

IOH [n (%)] (n 5 16)

Olfactory Symptom

P -Value

Osmophobia

96 (98) 91 (93)

12 (75) 11 (68) 3 (18) 4 (25) 3 (18)

.002 .001 .058 .001 .002

Crisis triggered by odors Olfactory hallucinations

4 (4) 1 (1)

Phantosmia

Perfume* Cleaning product

Cigarret Car smoke Rubber Leather Coffee Fish

Cacosmia/euosmia

0

most highly cited trigger (81%), followed by cigarette smoke (71%), and car smoke (70%). The odors cited as causes of osmophobia were similar. Thus, osmo phobia was most commonly attributed to perfume (88%), followed by cleaning products (70%), ciga rette smoke (68%), and automobile exhaust (62%). The frequency of crisis ( < 10/year; 11–20/year, > 20/year) was not related to the percent of subjects experiencing osmophobia ( P 5 .33). Patients with 1–10 crisis per year did have a higher prevalence of phantosmia than those who have more than 10 cri sis per year ( P 5 .01). Subjects who did not have IOH had higher rates of osmophobia ( P 5 .002) and crisis triggered by odors ( P 5 .001) than those who did have IOH. Subjects with IOH had higher rates of phantosmia ( P 5 .001) and cacosmia/euos mia ( P 5 .002) than those without IOH (Table 2). DISCUSSION The present study is the most definitive study, to date, in characterizing the olfaction-related symptoms experienced by migraineurs. Importantly, it sought to determine differences between such symptoms of migraine patients with and without auras. 6,10 Although our questionnaire of olfactory symptoms has not been previously validated, which is a limitation of this study, their items were based on symptoms and questions from other surveys exploiting the topic. 6,8,14,23 Osmophobia was found in 95% of the subjects, the highest prevalence rate Fig. 3.—Main odorants triggering crisis in migraineurs with auras (MA) and migraineurs without auras (MwA) (n total 5 total number of patients). Chi-square and Fisher’s exact tests, * P < .05.

Chi-square and Fisher’s exact tests used.

respectively, for the other groups of olfactory acuity ( P < .05). As shown in Figure 2, the main trigger of crisis was stress (96%), followed by odors (90%). Howev er, 97% of the subjects who reported that odors triggered their headaches also reported that stress did so as well. Food as a trigger of headache was more frequent in subjects who also reported odors as an initial cause of their headaches ( P 5 .01). Physical exercise was less common trigger of migraine, although it was more prevalent in the group with auras ( P 5 .01). Odors that triggered the crisis are listed in Figure 3. Perfume was the most frequent trigger (95%), with a higher prevalence in the group without auras ( P 5 .02). Cleaning products were the second

Fig. 2.—Percentage of main crisis triggers among migrai neurs with aura (MA) and migraineurs without auras (MwA) (n total 5 total number of patients). Chi-square and Fisher’s exact tests, * P 5 .01.