Raimundo Pereira Silva-Néto
Background: Osmophobia is defined as intolerance to odors and it is associated to primary headaches, particularly to migraine with or without aura. It occurs during headache attacks and/or in the period between headache attacks. It is not yet known specific treatment for osmophobia. Case: We describe a case of a 38-year-old woman diagnosed with migraine without aura according to ICHD- 3 criteria. She complained of severe osmophobia both during and between headache attacks. In the pain-free period, she had extreme intolerance to any odors. Physical examination and imaging were unremarkable. Several prophylactic treatments of migraine were administered the past two years. There was a marked improvement in the frequency and intensity of headache attacks, but osmophobia remained unchanged. She would like to treat only her osmophobia. A prophylactic treatment with phenytoin was started to osmophobia, with disappearance of this symptom within 90 days. Conclusion: From our experience in this case, phenytoin should be considered as possible prophylactic treatment for osmophobia between headache attacks in migraine patients.
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