title: Accuracy of osmophobia in the differential diagnosis between migraine and tension-type headache.
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.
authors.affiliation: Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, PE, Brazil. Electronic address: neurocefaleia@terra.com.br.
authors.forename: Raimundo Pereira
authors.initials: RP
authors.lastname: Silva-Néto
authors.affiliation: Education and Research Israelite Institute Albert Einstein, Sao Paulo, SP, Brazil.
authors.forename: Mário Fernando Pietro
authors.initials: MF
authors.lastname: Peres
authors.affiliation: Neurology and Neurosurgery Unit, Federal University of Pernambuco, Recife, PE, Brazil.
authors.forename: Marcelo Moraes
authors.initials: MM
authors.lastname: Valença
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis* / Q000453:epidemiology; D000857:Olfaction Disorders / Q000175:diagnosis* / Q000453:epidemiology; D010698:Phobic Disorders / Q000175:diagnosis* / Q000453:epidemiology; D011446:Prospective Studies; D018781:Tension-Type Headache / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult
keywords: Headache; Migraine; Odors; Osmophobia; Sensibility; Specificity; Tension-type