Odorant substances that trigger headaches in migraine patients

Abstract

Objectives Our objective was to determine odorants that trigger migraine attacks and the time of onset of headache after exposure. Methods Migraine or tension-type headache patients, diagnosed according to the criteria of the International Classification of Headache Disorders-II, were interviewed about lifetime prevalence of headaches triggered by odors and time of onset of pain, after exposure of the patient to the odor. Results We studied 200 migraine patients and 200 tension-type headache patients. There were odor-triggered headaches after 25.5 ± 1.9 minutes of exposure in 70.0% (140/200) of migraine patients and none with tension-type headache, which ran at low sensitivity (70.0%, 95% CI 63.1–76.2) and high specificity (100.0%, 95% CI 97.6–100.0). Odor-triggered headaches are distributed in the following order of frequency: perfumes (106/140, 75.7%), paints (59/140, 42.1%), gasoline (40/140, 28.6%) and bleach (38/140, 27.1%). There was significance in the association of odor-triggered migraine, especially among perfume with cleaning (phi = –0.459), cooking (phi = 0.238), beauty products (phi = –0.213) and foul odors (phi = –0.582). Conclusions Odorants, isolated or in association, especially perfume, may trigger migraine attacks after a few minutes of exposure.