Olfactory hallucinations in primary headache disorders: Case series and literature review

Elisheva R. Coleman, Brian M. Grosberg, Matthew S. Robbins

Research output: Contribution to journalReview articlepeer-review

45 Scopus citations


Background: Olfactory hallucinations (phantosmias) have rarely been reported in migraine patients. Unlike visual, sensory, language, brainstem, and motor symptoms, they are not recognized as a form of aura by the International Classification of Headache Disorders.Methods: We examined the clinical features of 39 patients (14 new cases and 25 from the literature) with olfactory hallucinations in conjunction with their primary headache disorders.Results: In a 30-month period, the prevalence of phantosmias among all patients seen at our headache center was 0.66%. Phantosmias occurred most commonly in women with migraine, although they were also seen in several patients with other primary headache diagnoses. The typical hallucination lasted 5-60 minutes, occurred shortly before or simultaneous with the onset of head pain, and was of a highly specific and unpleasant odor, most commonly a burning smell. In the majority of patients, phantosmias diminished or disappeared with initiation of prophylactic therapy for headaches.Conclusions: We propose that olfactory hallucinations are probably an uncommon but distinctive form of migraine aura, based on their semiology, timing and response to headache prophylaxis.

Original languageEnglish (US)
Pages (from-to)1477-1489
Number of pages13
Issue number14
StatePublished - Oct 2011


  • Migraine
  • aura
  • olfactory aura
  • olfactory hallucinations
  • phantosmia

ASJC Scopus subject areas

  • Clinical Neurology


Dive into the research topics of 'Olfactory hallucinations in primary headache disorders: Case series and literature review'. Together they form a unique fingerprint.

Cite this