Phantosmia (odor ghost), also called olfactory hallucinations , smells of a real odor. It can happen in one nostril or both. Unpleasant phantosmia, cacosmia , is more common and is often described as smelling of something that is burned, rotten, rotten, or rotten. Experiencing the occasional ghost odor is normal and usually goes away by itself in time. When hallucinations of this type do not seem to go away or when they keep coming back, it can be very annoying and can disrupt the quality of one's life.
Hallucinations of smell can be caused by common medical conditions such as nasal infections, nasal polyps, or dental problems. May occur due to neurological conditions such as migraine, head injury, stroke, Parkinson's disease, seizures, or brain tumors. It can also be a symptom of certain mental disorders such as depression, bipolar disorder, intoxication or withdrawal from drugs and alcohol, or psychotic disorders. Environmental exposures are sometimes the cause, such as smoking, exposure to certain types of chemicals (eg, insecticides or solvents), or radiation treatments for head or neck cancer.
A doctor can determine whether the problem is with the sense of smell (olfactory system) or taste (stimulant system), or whether it is caused by a neurological or psychiatric disorder. Phantosmia usually goes away by itself, although it can sometimes be gradual and occurs over several years. When it is caused by a disease (eg, sinusitis), it must go away when the disease is healed. If the problem persists or causes significant discomfort, your doctor may recommend nasal drops, antidepressants or anticonvulsants, nasal anesthesia, or in very rare circumstances, surgical procedures to remove nerves or olfactory bulbs.
Video Phantosmia
Symptoms
Other olfactory disorders such as hyposmia and anosmia have been found as symptoms of mood disorders (depression). However, no known olfactory disorder is occurring and whether it is actually a symptom of depressive disorder. It has been found that phantosmia may be an early sign of neurodegenerative disease of Parkinson's disease. It can also be a sign of intracranial hemorrhage (brain tumor or epilepsy). Other studies have also found that phantosmia symptoms have decreased after patients were treated for depression. Another case of a 70-year-old man reported that his first abnormal symptoms were irregular bowel movements. After this the patient develops irregular eye movements and has developed sleep disorders and behaviors after this he develops phantosmia; which is described as "odor and unpleasant". Patients do not show the following symptoms: loss of consciousness, confusion, automatism, seizures convulsions, auditory/visual hallucinations.
Maps Phantosmia
Cause
The cause of phantosmia may be peripheral or central, or a combination of both. The peripheral explanation of this disorder is that the damage of the neurons is mischievous and sends the wrong signal to the brain or may be due to impaired olfactory neuron function. The main explanation is that brain cells that are active or not working properly cause the perception of a disruptive odor. Another major cause is that phantom odor perception usually follows after a seizure. The duration of symptoms usually lasts a few seconds.
Other studies in phantosmia patients have found that odor perception begins with sneezing, so they avoid nasal activity. It has also been found that smelly perception is worse in the weaker nostrils in olfactory ability. It has also been noted that about a quarter of patients suffering from phantosmia in one nostril will usually develop it in other nostrils as well over a period of months or years.
Some patients who have received surgical treatments claim that they have a feeling or intuition that the smell of ghosts will occur, but not. This sensation has been supported by positron emission tomography, and it has been found that these patients have high levels of activity in their contralateral frontal, contral and temporal areas. The significance of activity in this region is not definitive because not a large number of patients have been studied to conclude this activity relationship with symptoms. However, the intensity of activity in this area is reduced by removing the olfactory epithelium from the associated nasal cavities.
There are several causes for phantosmia, but one of the most common and well-documented involves brain injury or seizures in the temporal lobes. During a temporal lobe attack the victim rarely passes out, but usually the blacks come out and can not remember anything that occurs during a seizure. Some people who have experienced these seizures, however, recall having phantosmia shortly before fainting. Epilepsy is a disease characterized by seizures. In the case of phantosmia, if smelly and something else becomes closely related, the action of "something else" happens can lead to activation of the bulb olfactory although there is no stimulus for the bulb. This is an example of false plasticity. Those with temporal lobe lesions, often caused by a stroke but also from head to head trauma, also experience olfactory hallucinations.
Other major causes of phantosmia include neurological disorders such as schizophrenia and Alzheimer's disease. Both of these disorders have documented cases of hallucinations, most often visual and auditory. Both also, however, have examples of phantosmia as well, though not often. In both cases, the incidence of olfactory delusions is more common, especially in Alzheimer's, where it is very difficult to convince patients that this is actually hallucinatory and unreal. Especially in Alzheimer's disease, atrophy in the temporal lobe has been known to occur. As evidenced in trauma and seizures, phantosmia is strongly associated with this area; leading to its appearance in some Alzheimer's patients. Parkinson's disease patients can also experience phantosmia, as well as parosmia, but their appearance is less common than muscle tremors experienced by patients.
Neuroblastoma
Neuroblastoma is a rare form of malignant cancer that begins in the olfactory nerve. The olfactory nerve is responsible for sensation kissing. This cancer can become aggressive and develop into the ethmoid sinus, the brain cavity, surrounding the lattice plate. Tumors can be tested by performing surgical biopsies and possible treatment options including surgical removal of tumors, radiation therapy and chemotherapy. This can cause damage to the olfactory system and possibly produce phantosmia.
Development
Phantosmia's complaints involve the most common unpleasant perception of odors including "burned," "rotten," "rotten," "waste," "metallic" or "chemical." Sometimes the smell is described as exhaust fumes. This odor can be triggered by a strong odor, a change of nasal airflow, or even a loud noise; sometimes it happens spontaneously. Patients with Phantosmia complaints may recognize poor quality of life, with each meal having an unpleasant odor as well. The first onset of this disorder, usually spontaneous, lasts only a few minutes. The recurrence then gradually increases from monthly, then weekly, and then daily for a period of 6 months to a year. The duration of the perceived smell also increases over the same time, often lasting at most a day after 1 year. Some patients also claim that the smell they smell is different from the known odor.
Diagnosis
The most challenging task for testers is to determine and obtain the right symptoms and associate them with one of the olfactory disorders, as there are several and are interconnected with each other.
The first step usually done by the examiner is to investigate whether the problem is related to olfaction or hooking. Because the patient may have a certain body odor that causes them to have this perception.
If the examiner is able to confirm that the problem is olfactory, the next step is to determine which olfactory disorder the patient has. The following is a list of possible olfactory disorders:
- anosmia
- dysosmia
- hyperosmia
- hyposmia
- parosmia or troposmia
- phantosmia
The second step is very difficult for the examiner and the patient because the patient has some difficulty describing their perception of the ghost odor. Furthermore, the patient is in a position of stress and anxiety so it is important that the examiner be patient.
After determining the nature of the disorder, and confirming the phantosmia, the examiner should then have a patient describing their perception of phantom odor. In many cases, the patient describes the smell as something that is burned and rotten and has described it as unpleasant and rotten.
The third step for the examiner is to determine the patient's medical history to record head trauma, accidents, upper respiratory infections, allergic rhinitis or chronic rhinitis. Although this may be an event that has produced a ghostly odor, studies conducted by Zilstrof have found that the majority of phantosmia patients have no history of head trauma and upper respiratory infections.
Treatment
Due to abnormalities of the disorder there is no well-defined treatment. Sometimes patients are only told to live with the disorder or the patient ends up doing a "stereotypical method" that may help reduce the severity of the odor. This may include being forced to cry, bending over to hold your knees while holding your breath, rinsing your nose with brine and choking. All of these behaviors ultimately fail to complete the hallucinations. Various treatments such as prophylaxis have been suggested but more research is needed for confirmation. Also, due to poorly understood disorders, and having an analogy with some psychiatric conditions, some patients are told they have mental illness. It is also common for these patients to have thoughts of suicide because they are not given much support or hope from many doctors.
One of the proposed surgical treatments includes bulb bulb removal through a bifrontal craniotomy approach. But a backlash by Leopold, Loehrl and Schwob (2002) suggest that this process of ablation produces bilateral permanent anosmia and includes the risks associated with craniotomy. According to them, the use of transcasal transcasal epithelial transcasal exhibit is a safe and effective treatment for patients with unremitting Phantosmia with potentially avoidable olfactory function. Also be warned that surgery is a challenge and is associated with major risks, and that should be limited to the center of expertise.
On the other hand, many cases also report that the strength of their symptoms decreases with time. (Duncan and Seidan, 1995) A case involving long-term phantosmia has been treated with the use of anti-depressive drugs under the common name Venlafaxine. The drug brand name is Effexor. The relationship between mood disorders and phantosmia is unknown, and is a widely studied area. In many cases, phantosmia symptoms have diminished with the use of anti-seizure and anti-depressants that work on central and peripheral neurons.
The most commonly used treatment method is the removal of the olfactory epithelium or the bulb by surgery to relieve the patient of the symptoms. Other traditional methods include the use of topical anesthesia (Zilstorff-Pederson, 1995) and the use of sedatives.
nasal congestion
Many patients are looking for a quick form of relief to achieve it by rinsing the nose with saline solution. This treatment option is easily available and can be repeated several times throughout the day to get help. An example of a nasal spray that can be used to relieve symptoms is Oxymetazoline HCl, which seems to provide relief for longer periods of time. The relief achieved by the use of nasal sprays seems to be due to the blockage of the nostrils that do not allow air to enter the olfactory gap.
Topical solution
Another treatment option is HCl's topical cocaine solution which also provides relief for short periods of time by acting as anesthesia and desensitizing neurons of the nose. Topical solution applied to the nostrils. This topical solution can have some side effects because it has been found that some patients suffering from troposmia begin to show phantosmia symptoms after its use. Other patients lose the full function of the nostrils in which the drug is applied.
Venlafaxine
This antidepressant drug is serotonin norepinephrine reuptake inhibitor (SNRI). In a case study of a 52-year-old woman suffering from phantosmia for 27 years, the dose of 75 mg per day was relieved and relieved the symptoms. The drug was prescribed initially to treat his depression.
Genders and events
Phantosmia is most likely to occur in women between the ages of 15 and 30 years. The first hallucinations last from five to twenty minutes. It has also been found that the second hallucination will occur about a month later in the same way as the first. Over time, the length of hallucinations will begin to increase.
Pregnancy
A longitudinal study in pregnant women found that 76% of pregnant women experienced significant changes in gustation and olfactory perception. These are found to be caused and associated with their pregnancy. The study concluded that 67% of pregnant women had reported higher levels of sensitivity to olfaction, 17% had olfactory distortions and 14% had phantosmia; this distortion is very minimal towards the last stage of pregnancy and the majority are absent postpartum. In addition, 26% of these participants also claimed that they also experienced an increased sensitivity to bitter food and decreased sensitivity to salt. These findings suggest that pregnant women experience olfactory and taste perception during pregnancy. It has also been found that 75% of women change their diet during pregnancy. Further research is underway to determine the mechanism behind food cravings during pregnancy.
Co-occurrence with another annoyance
Phantosmia has been found coexist in patients with other disorders such as schizophrenia, epilepsy, alcoholic psychosis, and depression. It has also been found that many patients may start suffering from depression after the occurrence of phantosmia and have been looking towards committing suicide. The occurrence of depression is caused by phantosmia symptoms that are severe because everything even the food smells rotten, rotten and burned for these patients. At age 80, 80% of individuals develop an olfactory disorder. As many as 50% of these people suffer from anosmia.
Parkinson's disease
Previous research has shown that phantosmia may be one of the final complications of Parkinson's disease.
However, recent research has shown that phantosmia occurs early in disease progression and usually precedes several years of motor symptoms. In events where suggestions are then correct, according to some researchers, phantosmia can be used as a premiere biomarker of Parkinson's disease, for predicting Parkinson's development in a risk population. But there is a contradiction to this argument as well.
It should be noted that not all patients with Parkinson's disease show phantosmia. Only half of patients suffering from anosmia and hyposmia feel their deficits, even when they are specifically asked to do so. According to a study by Doty et al., 72% of patients with olfactory disorders are unaware of their deficits, making it difficult for physicians and specialists to really rely on the reliability of phantosmia as a biomarker.
Migraine
In 2011 Coleman, Grosberg and Robbins conducted a case study on patients with olfactory hallucinations and other primary headache disorders. In their long 30-month study, the prevalence rate for phantosmia was as low as 0.66%.
In their findings, it was observed that a typical hallucinatory period is 5-60 minutes, occurring before or with onset of headache, and usually consisting of unpleasant odors. It is also noted that phantosmia is most common in women with migraine complaints. In their study, prophylactic therapy for headaches helped to cure phantosmia in the majority of patients.
These findings are consistent with the findings of Schreiber and Calvert in 1986 which also mentions olfactory hallucinations before migraine attacks in their four subjects.
Case study
Surgical treatment with olfactory preservation
A 26-year-old woman was diagnosed with mononucleosis at age 18. After this diagnosis he started experiencing headaches on the right side of his head, and phantosmia in the left nostril that often coincided. The olfactory hallucinations reported by the woman are a mixture of unpleasant vinegars, fecal matter, and rotten eggs. This will happen daily starting in the morning, and the symptoms will worsen for several days before her menstrual period. If symptoms do not occur in the morning, they will be triggered by strong olfactory stimuli or with loud noises. Sometimes he can avoid symptoms of phantosmia by forcing himself to sneeze.
The woman consulted with many medical practitioners but could not receive a reliable diagnosis. He prescribed medicines including nasal steroid sprays and other drugs, but they will not relieve him of the headaches and phantosmia symptoms. Through chemosensory evaluation, it was found that the sense of smell and the feeling of working normally. Because some phantosmias are believed to be caused by a blockage causing the odor molecule to not reach the olfactory receptor, surgical doctors dilate the olfactory plug. Unfortunately, phantosmia symptoms remain. Furthermore, unsuccessful treatment includes the long-term disturbance of axonal projection of the main sensory sensory neurons into the olfactory bulb. This is achieved by intranasal irrigation with zinc sulfate.
Patients were successfully treated with surgical procedures involving permanent disturbance of the olfactory epithelium. This is done by surgical excision of the olfactory epithelial "plug" from the cribiform plate area. This excision is intended to break all fill olfactoria into the central nervous system from the left nostril. 5 weeks after surgery, the woman reported no symptoms of phantosmia, and her olfactory ability was maintained (Hornung et al., 1991).
Drug treatments
For 52-year-old women, phantosmia occurs as a fluctuating episode that occurs over a 27-year period, and there is no visible reason for the onset of symptoms. She can weaken the symptoms by rinsing her nose with saline solution, and by going to bed. The smell he would encounter was often very unpleasant, resembling the smell of burning and rotten fruits. When her family doctor prescribed her a venlafaxine antidepressant, she noticed that the drug resulted in the complete removal of her phantosmia symptoms. The discovery has led scientists and physicians to examine whether there is a link between phantosmia and mild depressive disorder, and this idea is supported by the increase in reported phantosmia after repeated transcranial stimulation used to treat depression.
Co-morbidity with Parkinson's disease
Symptoms of phantosmia are often seen in patients with Parkinson's disease. Occasionally, a patient will report an olfactory disorder before the onset of motor symptoms of Parkinson's disease. Therefore, phantosmia is often used as a potential marker for the diagnosis of Parkinson's disease.
In the case of a 57-year-old woman, a strong sense of smell is reported, ranging from the smell of perfume to the unpleasant "wet dog" smell. The episodes experienced will last between seconds and hours and will occur several times per day. The patient will report phantosmia symptoms, but will correctly identify the known odor and will claim to have no symptoms of odor loss. She has no history of epilepsy, and her electroencephalographic results are normal. Then, while phantosmia symptoms decline, he develops symptoms of severe Parkinson's disease. While patients are treated for tremor with pramipexole, amantadine hydrochloride, levodopa, carbidopa and entacapone, phantosmia symptoms disappear completely.
In the case of a 52-year-old woman, the first symptom of phantosmia is reported to appear to the woman as an increase in olfaction. He believes it has the ability to detect smell before others, and with better accuracy. He then begins to experience typical phantosmia symptoms and will smell things he can recognize in the absence of an odor that produces molecules. The reported odors are perfume, candles, and fruits, but she can not accurately identify what kind of perfume or fruit she kissed. The episode of his phantosmia will happen suddenly and will last from minutes to half an hour. The rhinologic examination returned with normal results. When her phantosmia symptoms begin to disappear, she begins to complain of awkwardness, slowness, and trouble with her left hand that will alternate between tremor and stiffness. Neurological examination shows symptoms of Parkinson's disease.
See also
Related interruptions
- Anosmia
- Dysosmia
- Hyperosmia
- Hyposmia
- Parosmia (or troposmia)
More
- Odor binding protein
- Breath smell receptors
- Olfactory mitral cell bulb
- olfactory receptor neurons
- olfactory tubercle
References
Further reading
- Keller, Andreas & amp; Malaspina, Dolores (2013). "Hidden Consequences of Olfactory Dysfunction", at: BMC Ear Nose Throat Disorders 13: 8
- Levitan EB, Kaczmarek LK (2002). Neurons: Cell and Molecular Biology (3rd ed.). New York: Oxford University Press. ISBN: 978-0-19-514523-6.
- Sobol S, Frenkiel S, Mouadeb D (2002). olfactory function (PDF) . Canada: Canadian Diagnostic Journal.
- Andrews JG (2009). A Life Pungent: The Smells in My Head . New York: The New York Times.
External links
- Mayo Clinic - What causes olfactory hallucinations (phantosmia)?
Source of the article : Wikipedia
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