RESUMO
OBJECTIVE: To report a migraineur with osmophobia and trigger to garlic and onion aroma. BACKGROUND: While odors serve as a trigger in 70% of migraineurs, alliaceous aromas have been described only rarely. Furthermore, nor has more than one type of alliaceous odor acted as a trigger in the same individual. Neither has migraine with aura been described as precipitated by such aromas. A patient experiencing migraines with aura, triggered almost exclusively by alliaceous aromas, is described. CASE STUDY: 32-year-old woman; 5 years previously felt nasal pruritis upon eating a red onion dip. Shortly thereafter, the mere aroma of raw onions caused a sensation of her throat closing along with an associated panic attack. Over the intervening years, upon exposure to onions and garlic aroma she experienced a fortification spectra and visual entopia, followed by a bipareital, crushing level 10/10 headache, burning eyes and nose, lacrimation, perioral paresthesias, generalized pruritis, nausea, fatigue, sore throat, dysarthria, confusion, dyspnea, palpitations, presyncopal sensations, hand spasms, tongue soreness, neck pain, phonophobia, and photophobia. These would persist for 1 hour after leaving the aroma. She was unresponsive to medication and would wear a surgical mask when out. The patient also experienced chemosensory complaints: dysosmias every few months; phantosmias of food or cleaning products every month for a minute of level 5/10 intensity; pallinosmia of onion or garlic odor for 30 minutes after exposure; and metallic pallinugeusia after eating with metal utensils. RESULTS: Neurological exam normal except for bilateral positive Hoffman reflexes. CHEMOSENSORY TESTING: Quick Smell Identification Test 3/3 and Brief Smell Identification Test 12/12 were normal. Magnetic resonance imaging and computed tomography with and without contrast normal. Allergy skin test was positive for garlic and onion. Nose plug and counter stimulation with peppermint prevented the onset of headaches and associated symptoms. CONCLUSION: This is the first report of migraines with aura triggered by more than one alliaceous compound in the same individual. Possible mechanisms include odor induced, emotional change, vasomotor instability, trigeminal-induced neurogenic inflammation, and allergic response. In alliaceous and odor-induced migraines, a trial of counter stimulation and nose plugs is warranted.
Assuntos
Allium , Enxaqueca com Aura/diagnóstico , Enxaqueca com Aura/etiologia , Odorantes , Adulto , Feminino , Alho/efeitos adversos , Humanos , Mentha piperita , Enxaqueca com Aura/fisiopatologia , Cebolas/efeitos adversos , Óleos de Plantas/uso terapêutico , Reflexo Anormal/fisiologia , Resultado do TratamentoRESUMO
Burning mouth syndrome affects 1-3% of the population The exact mechanism is unknown. Bartoshuk has demonstrated sweet hypogeusia in those with burning mouth syndrome. Intensification of sweet taste may compensate for this deficit and reduce the pain.
Assuntos
Síndrome da Ardência Bucal/tratamento farmacológico , Dor/prevenção & controle , Sacarose/análogos & derivados , Edulcorantes/uso terapêutico , Administração Tópica , Idoso , Síndrome da Ardência Bucal/complicações , Síndrome da Ardência Bucal/fisiopatologia , Células Quimiorreceptoras/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Projetos Piloto , Sacarose/administração & dosagem , Sacarose/uso terapêutico , Edulcorantes/administração & dosagem , Resultado do Tratamento , Nervo Trigêmeo/fisiopatologiaAssuntos
Transtornos do Olfato/diagnóstico , Transtornos Parkinsonianos/diagnóstico , Lesão Encefálica Crônica/diagnóstico , Diagnóstico Diferencial , Feminino , Seguimentos , Alucinações/diagnóstico , Alucinações/etiologia , Humanos , Pessoa de Meia-Idade , Exame Neurológico , Transtornos do Olfato/etiologia , Doença de Parkinson/diagnóstico , Putamen/patologia , Recidiva , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
This article discusses the many factors that can influence odor perception, including association, expectancy and context and a good number of perceiver response variables such as age and gender as well as personality type. A historical background is included together with a wide range of references.
RESUMO
Adverse effects of acute exposure to hydrogen sulfide (H2S) are well documented, but long-term effects of occupational exposure to low levels of the gas are not. To evaluate effects of such exposure we performed physical, neurologic, psychiatric, and chemosensory (smell and taste) examinations of four workers who were present but did not lose consciousness when the gas was accidentally released at a construction site. None of the four workers tested positive for functional problems, but all met diagnostic criteria for at least three, and up to eight, H2S-induced neuropsychiatric clinical disorders and from zero to two subclinical disorders. All four had abnormal P300 evoked responses (electrical neurophysiologic tests of brain waves). Our data indicate that exposures to even relatively low concentrations of H2S are hazardous. A rigorous epidemiologic investigation of persons who work with H2S is warranted.