Author(s)
Erin Briggs
Anuja Shah, Clinical Research Fellow
Shaun Nguyen, Dr.
Alexander Duffy, MD
Zachary Soler, MD, FARS
Rodney Schlosser, MD, FARS
Affiliation(s)
Medical University of South Carolina;
Abstract:
Background: Patients with migraine often experience accompanying symptoms of olfactory dysfunction (OD) among other sensory disturbances. Osmophobia, a little-known associated symptom of migraine, is described as a fear, aversion, or hypersensitivity to odors. The objective of this study is to determine the prevalence of OD in patients with migraine and further characterize osmophobia.
Methods: The literature was searched for articles reporting prevalence of OD in patients with migraine. Primary outcome measures included proportions (%) and odds ratio (OR) with 95% confidence intervals (CI).
Results: 58 studies were included (N=22,170 patients). The prevalence of osmophobia among patients with migraine was 47.5% [95% CI: 42.0%-53.1%]. Olfactory hypersensitivity occurred during migraine attacks in 40.1% [95% CI: 23.1%-58.55] of patients. Migraine attacks triggered by odor occurred in 38.7% [95% CI: 32.1-45.5] of patients with perfume as the primary trigger. Patients that experienced osmophobia were at greater risk of experiencing other sensory disturbances, such as photophobia, nausea, and aura (OR = 1.45, 1.73, 1.66, respectively, all p < 0.0001).
Conclusion: Olfactory dysfunction (OD) is a significant and underrecognized component of migraine. In this study, nearly half of patients with migraine reported osmophobia and over a third identified specific odorants, such as perfume, as a trigger of migraine attacks. Of note, true prevalence of OD is hard to discern as studies were selected based on reporting of OD. This study furthers the understanding that OD can be a concomitant symptom in patients with migraine, and has association with other sensory disturbances, which may guide both diagnosis and management of migraine.