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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.

Phenytoin in the Treatment of Osmophobia in Migraine Patient: A Case Report