I appreciate the excellent paper on multiple chemical sensitivity (MCS) in migraine patients by Suzuki et al.¹ This study reported that 19 (20%) of a group of 95 adolescents and adults with chronic migraine met Quick Environmental Exposure Sensitivity Index (QEESI) criteria for MCS.¹ Among the 19 migraine patients with MCS, the levels of sensory aura, central sensitization, and osmophobia (sensitivity to odors).were significantly higher than for the 76 migraine patients without MCS.¹

A number of studies have reported that exposure to lower to moderate levels of many chemicals, including exposure to pesticides, organic solvents, and outdoor levels of many pollutants including PM_2.5, CO, NO₂, and SO₂, are associated with increased risk of migraines and other headaches.^2-4

In 1992, Martin and Becker reported on a group of 50 patients who experienced severe headaches from low-level exposure (43 patients) to high-level exposure (7 patients).⁵ The most common exposures included solvents in 34 cases, formaldehyde and/or ammonia in 8 cases, and pesticides in 4 cases. The average length of headache following chemical exposures was 4.9 hours. Most of these patients with headache began to experience many repeated headaches and were experiencing severe headaches at much lower levels of chemical exposures than before. Martin and Becker called this syndrome chemical headache exposure syndrome (CHES) and it shares many features with MCS.

Thanks again for the important paper on MCS and migraines. There is a need for much more research on migraines, low-level chemical exposure, and MCS.

我很欣赏 Suzuki 等人关于偏头痛患者多种化学敏感性 (MCS) 的优秀论文。¹这项研究报告说，在一组 95 名患有慢性偏头痛的青少年和成人中，有 19 名 (20%) 符合 MCS 的快速环境暴露敏感性指数 (QEESI) 标准。¹在 19 名患有 MCS 的偏头痛患者中，感觉先兆、中枢敏化和渗透恐惧症（对气味的敏感性）的水平明显高于没有 MCS 的 76 名偏头痛患者。^1个

许多研究报告说，暴露于较低至中等水平的许多化学品，包括暴露于杀虫剂、有机溶剂和室外水平的许多污染物，包括 PM _2.5、CO、NO ₂和 SO ₂，​​与增加的风险相关偏头痛和其他头痛。^2-4

1992 年，Martin 和 Becker 报告了一组 50 名患者，他们经历了从低水平暴露（43 名患者）到高水平暴露（7 名患者）的严重头痛。⁵最常见的暴露包括 34 例溶剂、8 例甲醛和/或氨以及 4 例杀虫剂。接触化学品后头痛的平均持续时间为 4.9 小时。这些头痛患者中的大多数开始经历许多反复的头痛，并且在比以前低得多的化学暴露水平下经历严重的头痛。Martin 和 Becker 将此综合征称为化学性头痛暴露综合征 (CHES)，它与 ​​MCS 有许多共同特征。

再次感谢关于 MCS 和偏头痛的重要论文。需要对偏头痛、低水平化学品暴露和 MCS 进行更多研究。