Porta-Etessam J, Casanova I, García-Cobos R, Lapeña T, Fernández M J, García-Ramos R, Serna C
Unidad de Cefaleas, Servicio de Neurología, Hospital Universitario Clínico San Carlos, Madrid.
Neurologia. 2009 Jun;24(5):315-7.
Osmophobia is often reported by migraine patients. This study evaluates osmophobia in connection with the diagnosis of episodic migraine with or without aura, chronic migraine and episodic and chronic tension-type headache.
We recruited from our Headache Unit 68 patients (59 female, 9 male; age 37+/-14.7 years), of whom 24 were migraine without aura (MoA), 11 migraine with aura (MA), 10 chronic migraine (CM) and 23 TTH (episodic-TTH). Patients with two or more forms of primary headache were excluded.
Among migraine patients, 54% with MoA and 0% with MA, 40 %CM reported osmophobia during the attacks; none of the 23 TTH patients suffered this symptom. The crisis frequency was MoA and osmophobia 2.15 crisis per month; MoA without osmophobia 3,14. MC with osmophobia 22; MC without osmophobia 21.7.
Osmophobia and taste abnormalities were demonstrated to be very specific in diagnosing migraine, but very insensitive. Osmophobia frequency does not depend on migraine frequency. Osmophobia seems to be more frequent in females than in males. The lack of osmophobia in MA patients could be explained by a different pathophysiological mechanism between MA and MoA.
恐水症常被偏头痛患者提及。本研究评估了与伴或不伴先兆的发作性偏头痛、慢性偏头痛以及发作性和慢性紧张型头痛诊断相关的恐水症。
我们从头痛科招募了68名患者(59名女性,9名男性;年龄37±14.7岁),其中24名是无先兆偏头痛(MoA),11名是有先兆偏头痛(MA),10名是慢性偏头痛(CM),23名是紧张型头痛(发作性紧张型头痛)。排除患有两种或更多种原发性头痛形式的患者。
在偏头痛患者中,54%的无先兆偏头痛患者和0%的有先兆偏头痛患者、40%的慢性偏头痛患者在发作期间报告有恐水症;23名紧张型头痛患者中无人有此症状。发作频率方面,无先兆偏头痛且有恐水症的患者每月发作2.15次;无先兆偏头痛且无恐水症患者每月发作3.14次。慢性偏头痛且有恐水症患者每月发作22次;慢性偏头痛且无恐水症患者每月发作21.7次。
恐水症和味觉异常在诊断偏头痛方面具有很高的特异性,但敏感性很低。恐水症的发作频率并不取决于偏头痛的发作频率。女性似乎比男性更易出现恐水症。有先兆偏头痛患者不存在恐水症这一现象,可能是由于有先兆偏头痛和无先兆偏头痛之间存在不同的病理生理机制。