Olfactory aura symptoms

"Parosmia involves a distortion of the sense of smell -- the affected person reports smelling something other than the scent which is present -- for example, the person sniffs a banana but it smells like rotting flesh instead of a banana. Phantosmia involves olfactory hallucinations -- that is, there is no odorant present, but the affected person reports smelling something, usually something unpleasant."

(Dr. Karl L. Wuensch, East Carolina University, December 18, 2004)

Both types of olfactory disturbances can occur as migraine aura symptoms. A major differential diagnosis to be considered in each case presenting with olfactory symptoms is temporal lobe epilepsy, now more commonly called complex partial seizure disorder, so that a neurological inquiry is mandatory in these patients to exclude temporal lobe lesions (McAbee et al., 2000).

Parosmia (Olfactory illusions)

"But the weird thing is that certain smells are wrong during my aura, kind of like a odor hallucination. The one that I have been able to identify is that sweat/body odor will smell like beer. I do not know if other things smell wrong - considering it took me 8 years to figure the sweat/beer thing out. My neuro said that this is not common to migraineurs, although it does happen, but that this smell problem is very common with seizures."

(Hannah Cox Peralta, Newsgroups: alt.support.headaches.migraine, Subject: Smells triggering headaches... - musk - peppermint - the grape flavouring they use in bubble gum, October 10, 1997)

"I have this sometimes as an aura or during my migraine. The only thing is that it took me almost 7 years of migraines to find this out. Most of the time the things that I smell I just assume are real. To me, when I am having such an episode, sweat/body odor smells like beer. I discovered this one day after my husband came home after playing 4 hours of handball. He doesn't drink and he smelled like he had an entire bottle of beer poured over him. In addition at work when I walk past the locker room for maintenence I smell the beer. When I told the neuro she said that it was more common to seizures but that it was not unheard of with migraines. My thought when she told me that was that since it took me 7 years to realize this myself that it might actually be more common, simply because unless it is a noxious odor you may not actually comment on the smell to others and find out that you are the only one smelling it."

(Hannah Cox Peralta, Newsgroups: alt.support.headaches.migraine, Subject: Smelling things, December 4, 1997)

Phantosmia (Olfactory hallucinations)

Diggiemoon, Migraine, 2000. © 2000 Diggiemoon (see here)

Some migraineurs may have olfactory auras involving smelling odors not actually present (Wolberg and Ziegler, 1982). In the drawing Migraine, American artist Diggiemoon represented his aura experience of phantosmia thus: "In front of my face is an apple split because during that time I had a strong nose and I'd always smell apples before getting sick for some reason." (Diggiemoon, artist's website, May 1, 2003) A GOOGLE search produces many examples of first-hand accounts in Usenet Newsgroups and other sources from the Internet. One migraine sufferer "wondered if anyone knew what the most common smells are?" (Beverly J. Unkefer, Newsgroups: alt.support.headaches.migraine, Subject: Odor ... Aura?, March 1, 2002) The following collection of reports from the Internet shows that there is a clear predominance of unpleasant smells, in one case echoing the horrors of Stephen King's and Peter Straub's (1984) novel The Talisman where the authors describe a smell like "sh-t and rotting grapes". Only few migraineurs are so lucky to smell fresh flowers, mowed lawn, fresh baking bread, popcorn, roasting chicken, fruity and sweet bubblegum or "other worldly" odors before or during their headaches.

"i've recently started having smell 'hallucinations' at onset of migraine.... wood burning (this drove me crazy)."

(NME58, Newsgroups: alt.support.headaches.migraine, March 21, 1995)

"I also get odor auras at the onset of migraines. At first I thought something was burning, maybe a neighbor's wood stove, exhaust from a truck. I am particularly sensitive to smell, and have the nose of a bloodhound when I have a migraine. Well, the odor kept coming and I would end up with a migraine. It isn't exactly wood burning or exhaust or mildew, but similar, very unique. when I notice the smell I know a migraine is coming and is a 'bad' one. Sometimes I can get some meds first and that helps, sometimes it's too late."

(Karen Knox, Newsgroups: alt.support.headaches.migraine, March 21, 1995)

"Every time I have a migraine, my senses get short-circuited, so that some of the pain translates to an incredibly irritating smell of ozone and hot plastic."

(Nils Weinander, Newsgroups: alt.gothic, February 13, 1996)

"When I get them, I just want some passing soul to be kind and lop off the left side of my skull -- at the neck. I smell Ozone and burning plastic with a migraine, as well. But then, I smell that when I get near a box of ho hos. Strange."

(Mademoiselle Foo, Newsgroups: alt.gothic, February 13, 1996)

"For several years my migraines have always come with an aura of flashers followed by nausea and then pain. Recently I've had them with a strange smell aura or none at all... The only way to describe the smell is 'metallic'. Maybe coppery. I look around for something that smells like that and find nothing."

(Reimer, Newsgroups: alt.support.headaches.migraine, April 12, 1996, and Reimer, Newsgroups: alt.support.headaches.migraine, April 14, 1996)

"I also get this type of forewarning before a migraine (not always - probably half of the time) is about to hit - it is sort of a metallic type of smell but to me it also smells blood-like."

(Sherry, Newsgroups: alt.support.headaches.migraine, April 17, 1996)

"I'm glad to hear someone else has experienced a 'smell aura' associated with their headaches. It doesn't happen very often with me, but every now and then I will wake up in the middle of the night and swear I smell frying potatos. It's really strange - the last time it happened I just knew my husband had been cooking chicken noodle soup. I even got up to check! This only happens before a migraine sets in and it doesn't last long. My doctor didn't say much about it so I'm happy to hear other people experience it also. I'm not nuts after all!"

(Sammi Ridgeway, Newsgroups: alt.support.headaches.migraine, April 18, 1996)

"The Migraines usually give me a slight warning, an odor of something that isn't there such as glue, or oranges, and one time I had an overwhelming taste of mustard in my mouth."

(J. Kraft, Newsgroups: sci.med.nursing, September 15, 1996)

"Lately, I have had periods of smelling things that weren't there. Example, driving to work and smelling popcorn as clearly as if I was popping it in the car. Most frequently is the exremely sweet odor, such as that of bubblegum (fruity and sweet) when there is nothing around that would cause it... I have such frequent headaches, it's hard to tell if it is in conjunction with a migraine. If anything, it is before one starts."

(Bully Dog, Newsgroups: alt.support.headaches.migraine, November 26, 1997)

"I occasionally get transient smells when I'm gearing up for a big one. I'd never been able to describe the odor until I read the Stephen King book 'The Talisman' where he describes a smell like 'sh-t and rotting grapes.' For the past few years, the smelling episodes have been tapering off -- too bad the headaches didn't follow suit. Another smell I would pick up was a funeral home/sweet formaldehyde smell. It's probably best that they have essentially gone away because they certainly weren't pleasant to deal with. Do you find that you throw up worse when you get the smelling problems with a headache?"

(Jill Short, Newsgroups: alt.support.headaches.migraine, November 26, 1997)

"I used to smell things that weren't there and have things taste funny, too [i.e. gustatory hallucinations, see here]. This was back when my migraines were much worse. One night I was repeatedly awoken by the smell of freshly ground coffee. The smell was so strong I thought I might go crazy. It had disappeared by morning."

(Priscilla H. Ballou, Newsgroups: alt.support.headaches.migraine, November 29, 1997; additions in square brackets by Klaus Podoll)

"I am the woman who smells chicken boiling! It took a long time to figure out why I might be smelling that particular thing, but I finally made an association with that smell and pain. Back before I was having such terrible, daily migraines, they came haphazardly and in varying degrees of severity. Many were hormonal back then, I am sure. When I was in my fifth month of pregnancy, I got up one Sunday morning and put some chicken backs on to boil to make broth for chicken and dumplings (we were really poor back then and I was very frugal, not wasting a thing!). I was hurting, but thought my baby had just had an active night kicking; I wasn't used to that sensation yet, since she had been kicking only a few weeks. The pain got worse as the day wore on, so I was in bed and the smell of that chicken was permeating our mobile home. By 6 that evening, the chicken pot had been put in the refrigerator and I was on my way to the hospital, where I had my appendix removed later that night. Some years later, I began smelling that chicken boiling odor right before a real head-banging, hair-pulling migraine hit. I now know that this is the precursor to some of my worst headaches, and that there is a definite association between that smell and pain. Strangely enough, I can still boil chicken (old habits die hard) and if I don't have a headache, it doesn't trigger one. If I do have a migraine, it doesn't make it any worse. So it is the phantom odor, not the real odor, that is associated with the impending migraine pain! What tricks our minds can play!"

(Barbara Lemmond, Newsgroups: alt.support.headaches.migraine, December 2, 1997)

"My sense of smell goes out of whack! Whenever I 'smell' a skunk or some other unusual odor, I have learned to ask people around me if they can smell it. If the answer is yes, I take a couple of extra-strength Tylenol and the beginning of a headache which accompanied the whiff goes away. However, if the answer is 'no', I know that I had better take my Imitrex (I am at the point where half a tablet works) right away, or else... "

(Roberta Montpetit, Newsgroups: alt.support.headaches.migraine, July 2, 1998)

"I occasionally suffer from painless migraine headaches. During such an attack, I may smell some odor and I would bet the farm it was real, but no one else smells it. There is some preliminary scientific evidence to show that the regions of my brain are active in this hallucination exactly as if there were the actual molecules present in the air that stimulated my nasal receptors to produce that odor. So there is no way I can tell if the smell is real or not without asking someone else."

(S.P., Newsgroups: alt.support.crossdressing, Januar 5, 1999)

"This is going to sound really off-the-wall, but here goes... My son, who has migraines, also has on occasion, an odor, not one that smells unclean, just 'unusual'. It is sort of a bitter, sour smell. He seems to have it along with his headaches. I told you this would sound weird, but we're chasing every rabbit we can to get some answers."

(Sue Adams, Newsgroups: alt.support.headaches.migraine, August 23, 1999)

"I guess I'm nuts, as well, because, occasionally, I smell buttered toast or chicken soup before a migraine starts."

(Mary, Newsgroups: alt.support.headaches.migraine, July 28, 1999)

"I am trying to find any information I can read that discusses a symptom where one smells a peculiar unique odor (which doesn't really exist in reality). On occasion (usually not very often), I notice a smell that is similar to vinyl but I've determined that I'm the only person that smells this. I've asked others, when this happens, and nobody else smells anything unusual. Another reason I think I'm not smelling anything real is that I've noticed it at home, at work and in my car too. One time I called the facilities at my office to see if there's been a chemical leak or anything else that can cause this smell. The facilities person could not smell anything unusual. This mysterious smell is always the same thing. Similar to brand-new vinyl shower curtains... I did feel that there was an association with migraines because I did feel a slight headache hours later after noticing the smell... I have had the smell without a headache most of the time."

(D. Jacobs, Newsgroups: alt.support.disorders.neurological,
January 7, 2001, and D. Jacobs, Newsgroups: alt.support.disorders.neurological, January 9, 2001)

"I smell bleach. It always follows with a migraine. I was referred to a neurologist because smelling odors is something that they look at. But he said I have 'classic' migraines."

(Theresa, Newsgroups: misc.health.diabetes, January 20, 2001)

"Many people with migraine do not get the classic auras. Some, such as myself, may have an odor aura. Sometimes I smell something charcoally before an attack."

(Sue, Newsgroups: alt.support.headaches.migraine, October 28, 2001)

"I have recently been getting very typical visual migraine aura, some with and some without headache. A few times there has been the very strong odor of urine also although not at the same time as the visual aura. I have heard of people smelling things that are not there preceding a migraine but wondered if anyone knew what the most common smells are??"

(Beverly J. Unkefer, Newsgroups: alt.support.headaches.migraine, March 1, 2002)

"for me it smells like something between burnt toast and burning flesh.... ugh!"

(Psylocke, Newsgroups: alt.support.headaches.migraine, March 6, 2002)

"Sometimes I sense something like a rotten smell - nasty!"

(Alexandra4, Newsgroups: alt.support.headaches.migraine, March 6, 2002)

"Thanks! It's so nice to have somewhere to go to get a straight answer and find that i'm not crazy!!"

(Beverly J. Unkefer, Newsgroups: alt.support.headaches.migraine, March 7, 2002)

"I get a rotten meat smell. Used to clean out the fridge top to bottom like a nut.. Bun got 70% of his body burnt so that is a smell I hope to never smell again..."

(Ronnie, Newsgroups: alt.support.headaches.migraine, March 17, 2002)

"On the other hand, I get odor aura - I smell really other wordly smells before a bad migraine. Strange metallic odors that I've never smelled in reality."

(Peter, Newsgroups: alt.support.headaches.migraine, September 10, 2003)

"Diagnosed with Migraine for years now, my painful migraines began to change when I began the journey of menopause. For over 20 years I suffered twice monthly with a headache, when I should have been in menses, or mittelspurtz. Then about two years ago the pain somewhat lessened, and the smells (of cigarette smoke or diesel) became the norm. My neurologist explained what was happening and I suffer through. Taking Ibuprofen helps sometimes, as it did with the pain. I began taking hormone therapy (I’m 53) this month and the phantom odor has been horribly strong, even making it hard to breathe and take in a breath (as if I’m in an extremely smoky room, or car). Interesting to me is the fact that I just began taking hormones which seem to spur the migraine in the first place, and now the odors are so strong. Thought you might be interested. Thank you… Judy"

(Judy, Email to Klaus Podoll, May 14, 2007)

References

McAbee G, Sagan A, Winter L. Olfactory hallucinations during migraine in an adolescent with an MRI temporal lobe lesion. Headache 2000; 40: 592-594.
Wolberg FL, Ziegler DK. Olfactory hallucination in migraine. Arch Neurol 1982; 39: 382.

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