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J Neurol Sci. 2014 Apr 15;339(1-2):118-22. doi: 10.1016/j.jns.2014.01.040. Epub 2014 Feb 6.

Accuracy of osmophobia in the differential diagnosis between migraine and tension-type headache.

Author information

1
Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, PE, Brazil. Electronic address: neurocefaleia@terra.com.br.
2
Education and Research Israelite Institute Albert Einstein, Sao Paulo, SP, Brazil.
3
Neurology and Neurosurgery Unit, Federal University of Pernambuco, Recife, PE, Brazil.

Abstract

Our objective was to determine the accuracy parameters of osmophobia in the differential diagnosis between migraine and tension-type headache. Migraine or tension-type headache patients, diagnosed according to the criteria of the International Classification of Headache Disorders-II, were interviewed about osmophobia during the crisis and in the period between episodes. We studied 200 migraine patients and 200 tension-type headache patients. During the crisis, osmophobia occurred in 86.0% (172/200) of patients with migraine and 6.0% (12/200) of those with tension-type headache. In migraine, osmophobia was associated with photophobia and phonophobia (57/172, 33.1%) or with nausea, photophobia and phonophobia (92/172, 53.5%) and presented high sensitivity (86.0%, 95% CI 80.2-90.3) and specificity (94.0%, 95% CI 89.5-96.7), with low percentages of false positives (6.5%, 95% CI 3.6-11.4) and negatives (13.0%, 95% CI 8.9-18.4). In the period between attacks, osmophobia was restricted to migraine patients (48/200, 24.0%). The areas under ROC curves were: 0.903 ± 0.017 to osmophobia during crisis; 0.784 ± 0.025 between crises; 0.807 ± 0.023 to photophobia/phonophobia, and 0.885 ± 0.017 to pain developed by odors. Osmophobia may be a specific marker to differentiate migraine from tension-type headache, which suggests its inclusion within the criteria to diagnose migraine.

KEYWORDS:

Headache; Migraine; Odors; Osmophobia; Sensibility; Specificity; Tension-type

PMID:
24560462
DOI:
10.1016/j.jns.2014.01.040
[Indexed for MEDLINE]
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