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Dec162009

Olfactory Hallucinations

 

"Olfactory Hallucination" and "Phantosmia" refers to the same olfactory deficit. Affected individuals experience smells that are not physically there. This can be very disturbing, just like a real smell which source is not known can be disturbing.

Phantosmia and olfactory hallucinations have been described in Parkinson disease and psychiatric disorders, after accidents, in epilepsy and migraines, or as an effect from chemotherapy or from recreational drugs. However, very frequently, olfactory hallucinations appear without and other diagnosis.

Phantosmias and Parkinson disease. Landis BN, Burkhard PR. Arch Neurol. 2008 Sep;65(9):1237-9. 

Severe chemotherapy-induced parosmia. Müller A, Landis BN, Platzbecker U, Holthoff V, Frasnelli J, Hummel T. Am J Rhinol. 2006 Jul-Aug;20(4):485-6.

Olfaction in migraineurs. Hirsch AR. Headache. 1992 May;32(5):233-6.

 

At least in some cases, there is brain activity that correlates with the experience of the phantom smell (so patients are not simply "lying" about their symptoms). Similar research is also going on to investigate the phenomenon of "phantom legs" in which people with an amputated leg still report sensations from that leg also it is physically impossible.

Taste and smell phantoms revealed by brain functional MRI (fMRI). Henkin RI, Levy LM, Lin CS. J Comput Assist Tomogr. 2000 Jan-Feb;24(1):106-23.

 

A possible treatment is (or was) the administration of antipsychiotics that are usually used in patients with schizophrenia, like thioridazine or haloperidol which both were shown in some cases to inhibit the presence of the phantom smells. In extreme cases olfactory halucinations have been treated surgically by surgical excision of olfactory epithelium. Treatment with topiramate, an anticonvulsant, have also been described.

Long-term follow-up of surgically treated phantosmia. Leopold DA, Loehrl TA, Schwob JE. Arch Otolaryngol Head Neck Surg. 2002 Jun;128(6):642-7.

Successful treatment of phantosmia with preservation of olfaction. Leopold DA, Schwob JE, Youngentob SL, Hornung DE, Wright HN, Mozell MM. Arch Otolaryngol Head Neck Surg. 1991 Dec;117(12):1402-6.

Treatment of olfactory hallucinations with topiramate. Johnson J, Bourgeois JA, Quanbeck C. J Clin Psychopharmacol. 2006 Jun;26(3):340-1.

 

Although these hallucinations can be very unpleasant for those experiencing them, they are very interesting for researchers trying to understand how the sense of smell works. It has, for example, been proposed that the fact that some people who lost their sense of smell still experience specific and identifiable phantom smells shows that the identity of a smell does not depend on what receptors in the nose are activated, but on a higher cognitive function 

Phantom smelling. Grouios G.  Percept Mot Skills. 2002 Jun;94(3 Pt 1):841-50.

 

A nice review paper that discusses all types of olfactory dysfunctions including phantosmia can be found at the Sense of Smell Institute

 

In August 2009 there was an interesting essay in the NYTimes written by somebody suffering from phantosmia. There is also a Yahoo! group for people suffering from phantosmia. In 2011, Season to Taste and Remembering Smells, two memoirs by people with problems with their sense of smell have been published.

 

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    I know some information about Olfactory Hallucinationsmany individuals are touchy to specific odors, yet in an olfactory mental trip (phantosmia), you catch smells that aren't generally show in nature's turf.
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Reader Comments (7)

My sense of smell is extremely heightened during migraines. I don't know if this is significant, but just thought I would share it.

May 30, 2010 | Unregistered CommenterConnie Bumgarner

I am prone to migraines but these "smell" episodes are not corresponding with the migraines. Although as stated above by a poster, I do have a very strong sensitivity to odors when I am having a migraine.

The smell I smell is urine, very strong and almost always after I shower. How strange is that. I spray the shower with Lysol before and after a shower to no avail, the smell is there no matter what I do. It's very annoying and I have to ask my son to smell my cloths and towels for reassurance that I don't smell. =(

July 5, 2010 | Unregistered CommenterCrazy Sniffer

2 months ago I was in a serious car accident. Broke my sternum, some ribs, and fractured an ankle. I'm recovering well, but for the past 5 weeks or so I've experienced a very frequent (several times a day) smell. It's a weird smell that I'm not sure I'm identifying correctly, but I think it's the dry smell of the gray smokey stuff that filled the car when the airbags deployed. Out of nowhere, without thinking about the accident, the smell shows up. I've been searching online for anwers and this is the only place I saw mentioned "after an accident". Thank you! I was beginning to think I had some mental problem. I'd like to think I'm reasonably mentally stable and this gave me some hope. :-)

January 7, 2011 | Unregistered CommenterBonnie

When I was 14 or so, my family cat started having bladder issues. She peed in any basket or box, and on miscellaneous objects too. A favorite of hers were our bins of toys (my brother and I had an epic lego collection that we sadly had to part with) and full laundry baskets. I got so obsessed with trying to detect urine on my clothes and possessions that I actually started smelling it everywhere. In the mall I would smell it on new clothes, I'd smell it in my obviously piss free books and at school, and I finally threw out my favorite pair of boots because, despite everyone telling me they didn't smell even remotely like cat piss, to me they smelled so strongly I would actually gag a little. The smell continued to torment me for a few months after we got her bladder issue under control, and then at some point it just disappeared. I've not had such a thing happen since!

December 29, 2011 | Unregistered CommenterKirin Furst

I have had a problem that started 8 mos ago, I lost the sense of taste and smell, now about 3 weeks I have developed a phanthom smell which is disgusting, it smell live rotting garbage with a hint of amonia, it is driving me nuts, I have bee to a nose, throat and ear specialist for the lose of taste and smell, and he gave me a nose spray, I am on my third kind of nose spray and nothing except now I have this smell,my primary doctor sent me for an MRI, and it is neg, nothing and I had Blood work.. nothing.. now he has put me on the anti depression Venlafaxine, I have taken it twice so far.. so time will tell.. has anyone have any ideas? I need any help I can get.. TY Dee

November 7, 2013 | Unregistered Commenterdee

Hi All,

I had a brain bleed/SAH and was fine until my anti epilepsy drugs where upped. (As fine as I could be)

Do I have attacks or stick with the stench, guess no option I'll stinks as having fits are far worse.

Good luck All

Win

June 29, 2014 | Unregistered CommenterWin

stink not stinks

June 30, 2014 | Unregistered Commenterwin

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