Juvenile Headache Centre, Department of Paediatrics University of Padua, Italy.
Cephalalgia. 2012 Apr;32(5):401-6. doi: 10.1177/0333102412438975. Epub 2012 Mar 9.
Osmophobia is frequent in children with migraine (20-35%) but can also occur in up to 14% of cases with tension-type headache (TTH). So far, the prognostic role of this symptom in children with primary headaches has never been evaluated.
A longitudinal prospective study was conducted on 90 young patients with TTH (37 with osmophobia, 53 without osmophobia). We evaluated whether osmophobia could predict the diagnosis transformation from TTH to migraine after a 3-year follow-up.
In our cases the rate of diagnosis change was significantly greater in cases with osmophobia (62%) than in those without (23%). Osmophobia persisted at a 3-year follow-up in the majority of our cases (85%) and it was found to be one of the major predictors for the development of migraine; other predictors of evolution to migraine were phonophobia, a probable rather than certain diagnosis of TTH and olfactory triggers (p < 0.05).
Our data confirm that osmophobia has an important diagnostic and prognostic role in children with primary headaches and should be systematically investigated at diagnosis and during follow-up.
偏头痛患儿中嗅觉恐惧症较为常见（20-35%），但在紧张型头痛（TTH）患儿中也可发生，发生率高达 14%。迄今为止，该症状在儿童原发性头痛中的预后作用尚未得到评估。
对 90 例 TTH 年轻患者（37 例有嗅觉恐惧症，53 例无嗅觉恐惧症）进行了一项纵向前瞻性研究。我们评估了嗅觉恐惧症是否可以预测 3 年后 TTH 向偏头痛的诊断转变。
在我们的病例中，有嗅觉恐惧症的病例（62%）的诊断改变率明显高于无嗅觉恐惧症的病例（23%）。在我们的大多数病例中（85%），嗅觉恐惧症在 3 年随访时持续存在，并且是偏头痛发展的主要预测因素之一；偏头痛发展的其他预测因素包括恐声症、TTH 的可能而非确定诊断以及嗅觉触发因素（p<0.05）。
我们的数据证实，嗅觉恐惧症在儿童原发性头痛中具有重要的诊断和预后作用，应在诊断和随访时系统地进行调查。
