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

作者：Silva Neto Raimundo Pereira^*; Pietro Peres Mario Fernando; Valenca Marcelo Moraes

来源：Journal of the Neurological Sciences, 2014, 339(1-2): 118-122.

DOI：10.1016/j.jns.2014.01.040

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

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% Cl 89.5-96.7), with low percentages of false positives (6.5%, 95% Cl 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.

• 出版日期2014-4-15