Abstract

Background
Sensory system may be activated during migraine attacks. Visual and auditory system activation have been addressed and implicated as an item of ICHD-II migraine diagnostic criteria. Recently the activation of olfactory systems during migraine attack has been occasionally commented. The object of this study is to assess osmophobia and validation of alternative diagnostic criteria of migraine without aura in Korean headache patients Methods: One hundred eighteen headache patients who visited outpatient clinic from August 2007 to October 2007, were evaluated for characteristics and associated features of headache such as frequency, duration, location, quality of pain, nausea, vomiting, photophobia, phonophobia and osmophobia. Osmophobia was classified as hyperosmia, hyposmia and dysosmia. Results: Eighty patients(67.8%) were diagnosed as having migraine and twenty four patients(20.3%) were diagnosed as having tension-type headache according to ICHD-II. Six patients were diagnosed as having probable migraine, two patients were diagnosed as having probable tension-type headache, two patients were diagnosed as having cluster headache and four patients were diagnosed as other primary headache. Thirty one patients complained of osmophobia during headache(90.3% very frequently and 9.7% frequently). Thirteen of them reported hypersomia (41.9%), seventeen reported dysosmia(54.8%) and one reported hyposmia(3.3%). All patients who complained of osmophobia during headache attacks were migraneurs. According to alternative diagnostic criteria of migraine without aura, 61 patients were diagnosed as having migraine without aura. Sensitivity of alternative diagnostic criteria was 0.85(95% CI, 0.74- 0.91) and specificity was 1.00(95% CI, 0.93-1.00). Conclusions: Osmophobia was observed in around 40% of migraineurs and was specific to migraine. Alternative dia- gnostic criteria of migraine without aura may be a valid method of classification.