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The Journal of Headache and Pain

Official Journal of the "European Headache Federation" and of "Lifting The Burden - The Global Campaign against Headache"

The Journal of Headache and Pain Cover Image

Volume 16 Supplement 1

1st Joint ANIRCEF-SISC Congress

Open Access

O067. Osmophobia in allodynic migraine: role of frequency of attacks and headache duration

  • Carlo Lovati1Email author,
  • Luca Giani1,
  • Elisa Capiluppi1,
  • Giulia Preziosa1,
  • Domenico D'Amico2 and
  • Claudio Mariani1
The Journal of Headache and Pain201516(Suppl 1):A104

Published: 28 September 2015


MigraineSmall Sample SizeClinical ManifestationPrimary HeadacheCommon Symptom


Migraine is a primary headache with recurrent attacks of head pain with associated symptoms like nausea, phonophobia, and photophobia. Osmophobia, although not included in diagnostic criteria, seems to be a very migraine-specific symptom[1]. Cutaneous allodynia (CA) is also a common symptom in migraine, especially when frequency of attacks is high. CA is considered a clinical manifestation of central sensitization, a mechanism involved in migraine chronification[2]. Recent works put in evidence a relationship between the presence of osmophobia and CA in migraineurs[3]. This study was aimed to investigate possible clinical elements able to influence the relationship between osmophobia and allodynia in migraine.

Materials and methods

We enrolled 871 patients consecutively evaluated in our Headache Center. Chronic migraine was defined as a mean frequency of headache of at least 15 days per month. Two hundred and sixty-three patients had chronic migraine (63 with aura, ChMA, and 200 without aura, ChMO) and 608 were episodic (165 with aura, MA, and 443 without aura, MO).


Osmophobia was significantly more frequent among patients with CA with respect to patients without CA (33.9% vs 26.7%, p = 0.016 at Chi square test). The association between these two symptoms was significant only in chronic migraineurs, among which osmophobia was present in 39.4% of allodynic patients and in 24.1% of non-allodynic patients (p = 0.008 at Chi square test). No difference was found in the distribution of osmophobia comparing chronic migraineurs with and without aura (44% of ChMA and 37% of ChMO). Both CA and osmophobia were significantly more frequent among women with respect to men: CA was found in 30% of men and 55% of women (p < 0.001) and osmophobia in 18.2% of men and 32.6% of women (p = 0.001). The relationship between CA and osmophobia was confirmed in both ChMA and ChMO among women. Even if the proportion was similar, significance was not found among men, probably because of the smaller sample size. Osmophobic episodic migraineurs, both with and without aura, had a longer migraine history. This evidence was not found among chronic patients.


The highlighted relationship between allodynia and osmophobia seems not to be influenced by gender nor by aura. The observation that it is related to a higher frequency of attacks and longer history of migraine may be interpreted as a common consequence of central sensitization, able to induce in parallel a distortion of both cutaneous sensitivity (CA) and olfaction (osmophobia).

Written informed consent to publication was obtained from the patient(s).

Authors’ Affiliations

Headache Center, Neurology Unit, A.O. L. Sacco, Milan, Italy
Headache Center, C. Besta Neurological Institute and Foundation, Milan, Italy


  1. Baldacci F, et al: Clinical features associated with ictal osmophobia in migraine. Neurol Sci. 2015, 36 (1): 43-6. 10.1007/s10072-014-1903-5.View ArticlePubMedGoogle Scholar
  2. Louter MA, et al: Cutaneous allodynia as a predictor of migraine chronification. Brain. 2013, 136 (Pt 11): 3489-96.View ArticlePubMedGoogle Scholar
  3. Lovati C, et al: Osmophobia in allodynic migraineurs: cause or consequence of central sensitization?. Neurol Sci. 2015, 36 (Suppl 1): 145-7.View ArticlePubMedGoogle Scholar


© Lovati et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.


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