Parosmia and Phantosmia Advice Sheet

Total Page:16

File Type:pdf, Size:1020Kb

Parosmia and Phantosmia Advice Sheet PAROSMIA AND PHANTOSMIA ADVICE SHEET What is parosmia? Parosmia is the medical term for experiencing distortions of smell when presented with normal daily smells. It most commonly occurs when a loss of smell has occurred following a viral infection such as the common cold. Sufferers may experience the phenomenon some time after the original insult and typically the sensations are unpleasant e.g. coffee smells like burnt toast. What is phantosmia? Phantosmia is the sensation of an odour being present when it is not. This can also be known as an olfactory hallucination. You may feel convinced that the smell is coming from your immediate surroundings but other people near you will confirm that the particular smell is not present. This most commonly occurs after smell loss due to head injury. It is usually unpleasant (termed cacosmia) although it can occasionally be pleasant (euosmia). Occasionally a perceived bad smell that is not detected by others may actually be caused by the presence of an infection in the nose or sinuses and this should always be excluded. What can be done about this problem? As mentioned above, these symptoms are usually found together with smell loss (anosmia/hyposmia) and the cause for this should be identified. Treating this cause may in itself lead to an improvement in this symptom. If however parosmia or phantosmia becomes more disabling than the loss of smell or is the only symptom, you should be given specific treatment for this such as nose drops or tablets. With the passage of time, many cases of parosmia and phantosmia will become less troublesome and disappear. However there are some measures which you can try yourself. Manoeuvres to help ease paromsia and phantosmia • Valsalva (closing one's mouth, pinching one's nose shut while pressing out as if blowing up a balloon) • Head movements - try your head in different positions when symptoms occur • Stimulating the nose with other smells - such as with smell training (see separate leaflet) • Stimulating the nose with water - try some nasal douching (see separate leaflet) • Stimulating the nose with deep breaths in through the nose • Stimulating the nose with trigeminal nerve stimulants e.g menthol, horseradish, mustard, capsaiscin (pepper) spray .
Recommended publications
  • Two Cases of Intractable Auditory Hallucination Successfully Treated with Sound Therapy
    ORIGINAL ARTICLE International Tinnitus Journal. 2010;16(1):29-31. Two cases of intractable auditory hallucination successfully treated with sound therapy Yutaka Kaneko, M.D. 1 Yasuhiko Oda, M.D. 2 Fumiyuki Goto, M.D. 3 Abstract We report two cases of patients with schizoaffective disorder with treatment-refractory auditory verbal hallucinations (AVHs) who were successfully treated with sound therapy, which is effective to treat tinnitus. AVHs in both patients were alleviated within about one month, and no recurrence was reported for 31 and 17 months after the sound the- rapy together with medication. Further studies may confirm the therapeutic value of sound therapy in patients with intractable AVHs. Keywords: auditory hallucinations, sound therapy. 1 Kaneko Otorhinolaryngology Clinic, Sendai, Miyagi, 2 Kunimidai Hospital (Psychiatry), Sendai, Miyagi, and 3 Department of Otorhinolaryngology, Hino Municipal Hospital, Tokyo, Japan Corresponding Author: Yutaka Kaneko, M.D. Kaneko Otorhinolaryngology Clinic 2-9-14 Kunimi,Aoba-ku,Sendai 981-0943,Japan Tel & Fax: +81-22-233-7722 E-mail: [email protected] International Tinnitus Journal, Vol. 16, No 1 (2010) www.tinnitusjournal.com 29 INTRODUCTION levomepromazine and olanzapine, together with fluvo- xamine maleate and sodium valproate during her hos- Auditory hallucinations (AHs) are generally defined pitalization for 3 years. She then received a psychiatric as false perceptions manifesting as “voices commenting” referral to our ear clinic for audiological evaluation and or “voices conversing” in patients with schizophrenia and treatment in August 2006. Her hearing level, calculated schizoaffective disorder. Auditory verbal hallucinations as the average across the frequencies 250, 500, 1000, (AVHs) are one of the major symptoms for the diagnosis and 2000 Hz, was 13.8 dB in the right ear and 18.8 dB of these disorders as well as the evaluation of psychotic in the left ear.
    [Show full text]
  • Parosmia Due to COVID-19 Disease: a 268 Case Series
    Parosmia due to COVID-19 Disease: A 268 Case Series Rasheed Ali Rashid Tikrit University, College of Medicine, Department of Surgery/ Otolaryngology Ameer A. Alaqeedy University Of Anbar, College of Medicine, Department of Surgery/ Otolaryngology Raid M. Al-Ani ( [email protected] ) University Of Anbar, College of Medicine, Department of Surgery/Otolaryngology https://orcid.org/0000-0003-4263-9630 Research Article Keywords: Parosmia, COVID-19, Quality of life, Olfactory dysfunction, Case series Posted Date: May 10th, 2021 DOI: https://doi.org/10.21203/rs.3.rs-506359/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/15 Abstract Although parosmia is a common problem in the era of the COVID-19 pandemic, few studies assessed the demographic and clinical aspects of this debilitating symptom. We aimed to evaluate the socio-clinical characteristics and outcome of various options of treatment of individuals with parosmia due to COVID- 19 infection. The study was conducted at two main Hospitals in the Ramadi and Tikrit cities, Iraq, on patients with a chief complaint of parosmia due to COVID-19 disease. The study involved 7 months (August 2020-February 2021). Detailed demographic and clinical characteristics and treatment options with their outcome were recorded and analyzed. Out of 268 patients with parosmia, there were 197 (73.5%) females. The majority were from age group ≤ 30 years (n = 188, 70.1%), housewives (n = 150, 56%), non-smokers (n = 222, 82.8%), and associated with dysgeusia (n = 207, 77.2%) but not associated with nasal symptoms (n = 266, 99.3%).
    [Show full text]
  • Smell and Taste Loss Recovery Time in COVID-19 Patients and Disease Severity
    Journal of Clinical Medicine Article Smell and Taste Loss Recovery Time in COVID-19 Patients and Disease Severity Athanasia Printza 1,* , Mihalis Katotomichelakis 2, Konstantinos Valsamidis 1, Symeon Metallidis 3, Periklis Panagopoulos 4, Maria Panopoulou 5, Vasilis Petrakis 4 and Jannis Constantinidis 1 1 First Otolaryngology Department, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; [email protected] (K.V.); [email protected] (J.C.) 2 Otolaryngology Department, School of Health Sciences, Democritus University of Thrace, Dragana, 387479 Alexandroupoli, Greece; [email protected] 3 First Department of Internal Medicine, AHEPA Hospital, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; [email protected] 4 Department of Internal Medicine, School of Health Sciences, Democritus University of Thrace, Dragana, 387479, Alexandroupoli, Greece; [email protected] (P.P.); [email protected] (V.P.) 5 Laboratory of Microbiology, School of Health Sciences, Democritus University of Thrace, Dragana, 387479 Alexandroupoli, Greece; [email protected] * Correspondence: [email protected] or [email protected] Abstract: A significant proportion of people infected with SARS-CoV-2 report a new onset of smell or taste loss. The duration of the chemosensory impairment and predictive factors of recovery are still unclear. We aimed to investigate the prevalence, temporal course and recovery predictors in patients who suffered from varying disease severity. Consecutive adult patients diagnosed to be infected with SARS-CoV-2 via reverse-transcription–polymerase chain reaction (RT-PCR) at two Citation: Printza, A.; coronavirus disease-2019 (COVID-19) Reference Hospitals were contacted to complete a survey Katotomichelakis, M.; Valsamidis, K.; reporting chemosensory loss, severity, timing and duration, nasal symptoms, smoking, allergic Metallidis, S.; Panagopoulos, P.; rhinitis, chronic rhinosinusitis, comorbidities and COVID-19 severity.
    [Show full text]
  • Second Edition
    COVID-19 Evidence Update COVID-19 Update from SAHMRI, Health Translation SA and the Commission on Excellence and Innovation in Health Updated 4 May 2020 – 2nd Edition “What is the prevalence, positive predictive value, negative predictive value, sensitivity and specificity of anosmia in the diagnosis of COVID-19?” Executive Summary There is widespread reporting of a potential link between anosmia (loss of smell) and ageusia (loss of taste) and SARS-COV-2 infection, as an early sign and with sudden onset predominantly without nasal obstruction. There are calls for anosmia and ageusia to be recognised as symptoms for COVID-19. Since the 1st edition of this briefing (25 March 2020), there has been a significant expansion of literature on this topic, including 3 systematic reviews. Predictive value: The reported prevalence of anosmia/hyposmia and ageusia/hypogeusia in SARS-COV-2 positive patients are in the order of 36-68% and 33-71% respectively. There are reports of anosmia as the first symptom in some patients. Estimates from one study for hyposmia and hypogeusia: • Positive likelihood ratios: 4.5 and 5.8 • Sensitivity: 46% and 62% • Specificity: 90% and 89% The US Centres for Disease Control and Prevention (CDC) has added new loss or taste or smell to its list of recognised symptoms for SARS-COV-2 infection. To date, the World Health Organization has not. Conclusion: There is sufficient evidence to warrant adding loss of taste and smell to the list of symptoms for COVID-19 and promoting this information to the public. Context • Early detection of COVID-19 is key to the ongoing management of the pandemic.
    [Show full text]
  • Taste and Smell Disorders in Clinical Neurology
    TASTE AND SMELL DISORDERS IN CLINICAL NEUROLOGY OUTLINE A. Anatomy and Physiology of the Taste and Smell System B. Quantifying Chemosensory Disturbances C. Common Neurological and Medical Disorders causing Primary Smell Impairment with Secondary Loss of Food Flavors a. Post Traumatic Anosmia b. Medications (prescribed & over the counter) c. Alcohol Abuse d. Neurodegenerative Disorders e. Multiple Sclerosis f. Migraine g. Chronic Medical Disorders (liver and kidney disease, thyroid deficiency, Diabetes). D. Common Neurological and Medical Disorders Causing a Primary Taste disorder with usually Normal Olfactory Function. a. Medications (prescribed and over the counter), b. Toxins (smoking and Radiation Treatments) c. Chronic medical Disorders ( Liver and Kidney Disease, Hypothyroidism, GERD, Diabetes,) d. Neurological Disorders( Bell’s Palsy, Stroke, MS,) e. Intubation during an emergency or for general anesthesia. E. Abnormal Smells and Tastes (Dysosmia and Dysgeusia): Diagnosis and Treatment F. Morbidity of Smell and Taste Impairment. G. Treatment of Smell and Taste Impairment (Education, Counseling ,Changes in Food Preparation) H. Role of Smell Testing in the Diagnosis of Neurodegenerative Disorders 1 BACKGROUND Disorders of taste and smell play a very important role in many neurological conditions such as; head trauma, facial and trigeminal nerve impairment, and many neurodegenerative disorders such as Alzheimer’s, Parkinson Disorders, Lewy Body Disease and Frontal Temporal Dementia. Impaired smell and taste impairs quality of life such as loss of food enjoyment, weight loss or weight gain, decreased appetite and safety concerns such as inability to smell smoke, gas, spoiled food and one’s body odor. Dysosmia and Dysgeusia are very unpleasant disorders that often accompany smell and taste impairments.
    [Show full text]
  • Smell Distortions: Prevalence, Longevity and Impact of Parosmia in a Population-Based, Longitudinal Study Spanning 10 Years
    Smell distortions: Prevalence, longevity and impact of parosmia in a population-based, longitudinal study spanning 10 years Jonas K. Olofsson*1, Fredrik Ekesten1, & Steven Nordin2 1Department of Psychology, Stockholm University, Stockholm, Sweden 2Department of Psychology, Umeå University, Umeå, Sweden *Corresponding author: [email protected] Abstract. Parosmia, experiences of distorted smell sensations, is a common consequence of covid-19. The phenomenon is not well understood in terms of its impact and long-term outcomes. We examined parosmia in a population-based sample from the Betula study that was conducted in Umeå in northern Sweden (baseline data collected in 1998-2000). We used a baseline sample of 2168 individuals aged 35-90 years and with no cognitive impairment at baseline. We investigated the prevalence of parosmia and, using regression analyses, its relationship to other olfactory and cognitive variables and quality of life. Benefitting from the longitudinal study design, we also assessed the persistence of parosmia over 5 and 10 years prospectively. Parosmia was prevalent in 5% of the population (n=104) and was often co- occurring with phantosmia (“olfactory hallucinations”), but was not associated with lower self-rated overall quality of life or poor performance on olfactory or cognitive tests. For some individuals, parosmia was retained 5 years (17%) or even 10 years later (10%). Thus, parosmia is relative common in the population, and can be persistent for some individuals. This work provides rare insights into the expected impact of, and recovery from parosmia, with implications for those suffering from qualitative olfactory dysfunction following covid-19. 2 Introduction Parosmia is an olfactory disorder (OD) where odor perception is distorted and different stimuli trigger unpleasant odor sensations previously not associated with the stimuli (i.e.
    [Show full text]
  • For Personal Use Only
    Comments & Controversies p Coming to Ask more questions APA? suspected to be at risk for workplace MAY 2009 Visit us at booth The list of interview questions Dr. #1624 violence and for fi tness for duty. Mob- Henry Nasrallah suggested in “The bing seems to be more prevalent and hallucination portrait of psychosis: the consequences more dire for a vic- Probing the voices within” (From the A DOWDEN PUBLICATION • VOL. 8, NO. 5 Beyond threats tim who is feeling pressured to leave Editor, Current Psychiatry, May Risk factors for suicide his or her job when there is little hope in borderline personality 2009, p. 10-12) is a much-needed re- disorder of getting another one or is taking on ] SPECIAL REPORT minder of the clinical importance of Economic anxiety: First aid responsibilities previously held by oth- for the recession’s casualties patients’ verbal auditory hallucina- What is your patient’s ers who have been laid off. predicament? Knowing can tions. In 15 years of practice—much Mr. S experiences recurrent hypothermia inform clinical practice This brings to the forefront a very during treatment for multiple medical PLUS Editorial: Dr. Nasrallah problems and psychotic symptoms. of that inpatient psychiatry—I have Hallucination portrait of psychosis: important consideration for individu- Could antipsychotics be the cause? Probing the voices within Malpractice Rx cared for many patients with hallu- Smoking allowed: als who confront such assessment Is hospital policy a liability risk? Pearls cinations, and until recently I confess \DRiNK TWO 6 PACK challenges. Gathering collateral infor- clarifi es substance use ONLINE ONLY my interview was not as thorough as SEE PAGE 9 mation is critical for diagnostic accura- Dr.
    [Show full text]
  • The Effect of Delusion and Hallucination Types on Treatment
    Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2016;29:29-35 Research / Araştırma DOI: 10.5350/DAJPN2016290103 The Effect of Delusion and Esin Evren Kilicaslan1, Guler Acar2, Sevgin Eksioglu2, Sermin Kesebir3, Hallucination Types on Ertan Tezcan4 1Izmir Katip Celebi University, Ataturk Training and Treatment Response in Research Hospital, Department of Psychiatry, Izmir - Turkey 2Istanbul Erenkoy Mental Health Training and Research Schizophrenia and Hospital, Istanbul - Turkey 3Uskudar University, Istanbul Neuropsychiatry Hospital, Istanbul - Turkey Schizoaffective Disorder 4Istanbul Beykent University, Department of Psychology, Istanbul - Turkey ABSTRACT The effect of delusion and hallucination types on treatment response in schizophrenia and schizoaffective disorder Objective: While there are numerous studies investigating what kind of variables, including socio- demographic and cultural ones, affect the delusion types, not many studies can be found that investigate the impact of delusion types on treatment response. Our study aimed at researching the effect of delusion and hallucination types on treatment response in inpatients admitted with a diagnosis of schizophrenia or schizoaffective disorder. Method: The patient group included 116 consecutive inpatients diagnosed with schizophrenia and schizoaffective disorder according to DSM-IV-TR in a clinical interview. Delusions types were determined using the classification system developed by Gross and colleagues. The hallucinations were recorded as auditory, visual and auditory-visual. Response to treatment was assessed according to the difference in the Positive and Negative Syndrome Scale (PANSS) scores at admission and discharge and the duration of hospitalization. Results: Studying the effect of delusion types on response to treatment, it has been found that for patients with religious and grandiose delusions, statistically the duration of hospitalization is significantly longer than for other patients.
    [Show full text]
  • Olfaction in Migraine and Its Psychiatric Comorbidities: a Narrative Review
    Olfaction in migraine and its psychiatric comorbidities: a narrative review CIRO DE LUCA1, MD, MARTINA CAFALLI2, MD, ALESSANDRA DELLA VECCHIA3, MD, SARA GORI1, MD, ALESSANDRO TESSITORE4, PHD, MARCELLO SILVESTRO4, MD, ANTONIO RUSSO*4, PHD AND FILIPPO BALDACCI1, PHD. 1Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy. 2Unit of Neurorehabilitation, Department of Medical Specialties, University Hospital of Pisa, 56126 Pisa, Italy 3Unit of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy. 4Department of Advanced Medical and Surgery Sciences, Headache Center, I Clinic of Neurology and Neurophysiopathology, University of Campania "Luigi Vanvitelli", Naples, Italy Received: 28th September 2020; Accepted 12th October 2020 Abstract Objective Migraine is a primary headache with a constellation of neurovegetative and sensory-related symptoms, comprehending auditory, visual, somatosensorial and olfactory dysfunctions, in both ictal and interictal phases. Olfactory phenomena in migraine patients consist in ictal osmophobia, interictal olfactory hypersensitivity and an increased sensitivity to olfactory trigger factors. However, osmophobia is not listed as an associated symptom for migraine diagnosis in ICHD-3. Design We reviewed the literature about the anatomical circuits and the clinical characteristics of olfactory phenomena in migraine patients, and highlighted also the common comorbidities with psychiatric disorders. Discussion The evidence suggests a potential role of the olfactory dysfunctions as diagnostic, prognostic and risk biomarker of migraine in clinical practice. Olfactory assessment could be useful in reducing the overlap between migraine and other primary headaches - especially the tension type one - or secondary headaches (ictal osmophobia, olfactory trigger factors), and in predicting migraine onset and its chronic transformation (ictal osmophobia).
    [Show full text]
  • Gamma-Aminobutyric Acid (GABA) Is a Major Neuro­Transmitter Widely Distributed Throughout the Central Nervous System (CNS)
    Alternative Medicine Review Volume 12, Number 3 2007 Monograph GABA Gamma-Aminobutyric O + Acid (GABA) H3N O- Introduction Gamma-aminobutyric acid (GABA) is a major neuro transmitter widely distributed throughout the central nervous system (CNS). Because too much excitation can lead to irritability, restlessness, insomnia, seizures, and movement disorders, it must be balanced with inhibition. GABA – the most important inhibitory neurotransmitter in the brain – provides this inhibition, acting like a “brake” during times of runaway stress. Medications for anxiety, such as benzodiazepines, stimulate GABA receptors and induce relaxation. Either low GABA levels or decreased GABA function in the brain is associated with several psy- chiatric and neurological disorders, including anxiety, depression, insomnia, and epilepsy. Studies indicate GABA can improve relaxation and enhance sleep. Both synthetic and natural GABA are available as dietary supplements in the United States. Natural GABA is produced via a fermentation process that utilizes Lactobacillus hilgardii – the bacteria used to ferment vegetables in the preparation of the traditional Korean dish known as kimchi. Biochemistry and Pharmacokinetics Within the brain, glutamic acid is converted to GABA via the enzyme glutamate decarboxylase and its cofac- tor pyridoxal 5’ phosphate (P5P; active vitamin B6). GABA is metabolized by gamma-aminobutyrate transaminase, also a P5P-dependent enzyme, forming an intermediate metabolite succinate semialdehyde. This metabolite can then be reduced to gamma-hydroxybutyrate, or oxidized to succinate and eventually converted to CO2 and water via the citric acid cycle. When plasma membrane depolarization induces the release of GABA from nerve terminals, GABA binds to GABA receptors – such as the GABAA and GABAB receptors – that are distributed on post-synaptic cell membranes.
    [Show full text]
  • Sixty Seconds on . . . Parosmia
    NEWS The BMJ BMJ: first published as 10.1136/bmj.m4332 on 9 November 2020. Downloaded from Cite this as: BMJ 2020;371:m4332 Sixty seconds on . parosmia http://dx.doi.org/10.1136/bmj.m4332 Abi Rimmer Published: 09 November 2020 I’ve heard of anosmia but what's this? The charity Fifth Sense explains that parosmia is the medical term for distortions of the sense of smell. Someone with parosmia may be able to detect odours, but the smell of certain things—or sometimes everything—is different, and often unpleasant.1 Such as? Jennifer Spicer, a US based infectious diseases doctor, said that following her recovery from covid-19, coffee, wine, and other foods tasted like gasoline.2 Nicola Watt, who also recovered from the virus, described similar symptoms to the Times.3 “Quite suddenly everything smelt and tasted like a horrid rubbish bin,” Watt said. Sounds awful. Is this from covid-19? Not specifically. Parosmia is common with all types of post-viral smell loss, and over half of people who have lost their sense of smell because of a virus will go on to experience it.4 Fragrance writer Louise Woollam, for example, suffered from parosmia after a cold and found that most foods tasted of sewage or mud and most things smelt disgusting.5 How awful! Yes, and what’s worse Woollam, like many other people, experienced phantosmia as well when “phantom” smells appear in the absence of any odour. These can manifest as “normal” smells – for example, being able to smell garlic when there is no garlic present – but they can also be unpleasant.1 Is there a cure? Unfortunately not.
    [Show full text]
  • The Phenomenological Control Scale: Measuring the Capacity for Creating Illusory
    Norms for the Phenomenological Control Scale 1 1 The Phenomenological Control Scale: Measuring the capacity for creating illusory 2 nonvolition, hallucination and delusion. 3 Lush, P.* 1,2, Scott, R. B., 1,3, Seth, A.K.1,2,4 & Dienes, Z. 1, 3. 4 5 1 Sackler Centre for Consciousness Science, University of Sussex, Falmer, BN1 9RH, UK 6 2 Department of Informatics, Chichester Building, University of Sussex, Falmer, BN1 9RH, 7 UK 8 3 Department of Psychology, Pevensey Building, University of Sussex, Falmer, BN1 9RH, UK 9 4 Canadian Institute for Advanced Research (CIFAR) Program on Brain, Mind, and 10 Consciousness, Toronto, Ontario, MG5 1M1, Canada 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 *Corresponding author: [email protected] 27 1 Norms for the Phenomenological Control Scale 2 28 Abstract 29 Phenomenological control is the ability to generate experiences to meet expectancies. There 30 are stable trait differences in this ability, as shown by responses to imaginative suggestions 31 of, for example, paralysis, amnesia, and auditory, visual, gustatory and tactile hallucinations. 32 Phenomenological control has primarily been studied within the context of hypnosis, in 33 which suggestions are delivered following a hypnotic induction. Reports of substantial 34 relationships between phenomenological control in a hypnotic context (hypnotisability) and 35 experimental measures (e.g., the rubber hand illusion) suggest the need for a broad 36 investigation of the influence of phenomenological control in psychological experiments. 37 However, hypnosis is not required for successful response to imaginative suggestion. 38 Because misconceptions about the hypnotic context may influence hypnotisability scores, a 39 non-hypnotic scale which better matches the contextual expectancies of other experiments 40 and avoids the hypnotic context is potentially better suited for such investigation.
    [Show full text]