Author(s): SilvaNto RP, Peres MF, Valena MM
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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. Copyright © 2014 Elsevier B.V. All rights reserved.
This article was published in J Neurol Sci
and referenced in Journal of Clinical Case Reports