Olfactory Hallucinations During Migraine in an Adolescent With an MRI Temporal Lobe Lesion

Objective.—To report the first example of an abnormal magnetic resonance imaging (MRI) test in a patient with migraine and olfactory hallucinations and to provide additional evidence for a possible role of the temporal lobe in migraine. Background.—The relationship between the temporal lobe and migraine with or without hallucinations is unclear and continues to evolve. Clinical and functional neuroimaging studies (positron emission tomography/single photon emission computed tomography) have lent support to the possibility of a relationship. Anatomical neuroimaging with computed tomography has previously been normal. Methods.—The history and findings of an adolescent with migraine and olfactory hallucinations is reported. Results.—Brain MRI demonstrated a mass in the temporal lobe. Conclusions.—Magnetic resonance imaging should be considered in patients with olfactory hallucinations and migraine. In addition, the role of the temporal lobe in migraine warrants further study.