A Dislike of Strong Smells – A Childhood Migraine Indicator

Identifying migraines in childhood is a lot harder than diagnosing migraines in adults – and that can be hard enough as it is! In fact, nearly half of children with migraine never receive a diagnosis.

What makes childhood migraines so hard to recognise is that they don’t necessarily resemble your ‘typical’ (after all, all migraines are different so ‘typical’ is a slight misnomer) migraine.

For adults the most common migraine symptom is head pain on one side of the head, but for children the main symptom is not always head pain. If head pain is experienced, it typically affects the forehead and temple areas or whole head, rather than just one side of the head.

To make diagnosis even harder, some children don’t experience any head pain at all as part of their migraine attacks – hence why so many children with migraines go undiagnosed. Instead the main symptoms of migraine in children tend to be abdominal pain, cyclical vomiting, limb pain, and episodic dizziness. What may be one marker of migraine that could help to signal if a child is suffering from migraines though is osmophobia.

Osmophobia is an aversion to or dislike of strong smells. Many adult migraine sufferers report strong smells as being a migraine trigger – with the likes of perfumes and aftershaves, cigarette smoke, and some cleaning products all being particularly triggering.

However, since what is the case for adults with migraine is not necessarily the case for children with migraine, a study looking specifically at children’s reaction to smells in relation to migraines was needed.  

A 2020 study involving 300 child/adolescent patients, of whom 253 had migraine and 47 had a tension-type headache, found that 137 had osmophobia during their attacks. Those who did also had longer attacks which were more intense.

So, although not all of the patients had osmophobia or found strong smells to be a trigger for their attacks, it was concluded that osmophobia could be useful in diagnosing migraines in children. Especially as younger children may not be able to communicate exactly what symptoms they are feeling – making diagnosis of migraine that much more difficult.