Abstract

Objective: Osmophobia, intolerance to smell, is often reported by migraine patients during headache attack and is included as an item of alternative diagnostic criteria for migraine in the appendix of ICHD-2. Most of previous reports on osmo- phobia were hospital-based studies and osmphobia of migraineurs across population sample was not reported yet. The aims of this study are to assess osmophobia in migraineurs across Korean populationand to assess validity of alternative diagnostic criteria of migraine. Methods: We used data of Korean Headache Survey(KHS), a population-based study by a stratified random sampling in Korean population over age 19, and totally 1,507 were evaluated. Demographic profile, headache characteristics and impact of headache were assessed with a 12-item semi-structured interview. Headache type was identified according to ICHD-2. We assessed osmophobia by a question ‘Do you feel changes in your sense of smell during headache?(stronger or differently)’. Results: Prevalence for migraine was 6.1%. 50.5% of migraineurs reported osmophobia during migraine attack. Mig- raineurs with osmophobia had more headache aggravation by routine physical activity, phonophobia and higher HIT-6 score than migraineurs without osmophobia. There were no significant difference in unilaterality of pain, pain intensity in VAS score, pulsating quality and photophobia between migraineurs with osmophobia and migraineurs without osmo- phobia. The sensitivity of alternative criteria was 0.95[95% confidence interval(CI), 0.87-0.98] and specificity was 0.99(95% CI, 0.98-0.99). Conclusions: Approximately half of migraineurs across Korean population sample reported osmophobia. Alternative criteria showed good specificity and sensitivity.