Phantom smells (phantosmia) may be caused by conditions that affect the nose, paranasal sinuses, nerve fibers that carry smell sensations, or brain cells that process smell.
Major causes of phantosmia include:
- Conditions that affect the nose or sinuses
- Conditions that affect the brain
- Other causes
What are phantom smells?
Phantom smells are a type of olfactory hallucination. This means that the affected person experiences a smell that is not actually there. Symptoms may come and go, although they can cause significant distress to the individual.
Most people describe the smells to be offensive and intolerable, such as the smell of smoke, chemicals, sewage, moldy, spoiled food, or other foul odors. The phantom smell may be perceived through one or both nostrils.
Phantom cells can have a significant effect on mood, health, and personal relationships. The condition can also affect work performance, since many jobs may require you to have a good sense of smell (such as chefs). It may even be dangerous at times because you may not be able to perceive danger or warning smells, such as a gas leak or spoiled food.
Experiencing foul smells can make you nauseous and affect your appetite as well, leading to unhealthy weight loss, stress, anxiety, and depression. Therefore, it is important to seek timely medical help to rule out any serious health conditions (such as epilepsy or tumors) that may be causing your symptoms.
Are phantom smells the same as parosmia?
Phantom smells are not synonymous with parosmia.
Parosmia is a disorder of smell in which the smells are perceived differently than what they actually are. Unlike parosmia, phantosmia is not caused by a real substance. Both conditions, however, can cause significant distress, especially when chronic.
However, some experts consider phantosmia to be a type of parosmia. They define phantosmia as distorted odor perception that occurs in the absence of an odorant stimulus and troposmia as smell distortion in the presence of an odorant stimulus. Both conditions are classified as parosmia.
How are phantom smells diagnosed?
- Detailed medical history: Your doctor may ask you to describe your symptoms, including when they began and how often they occur, whether any other symptoms accompany them and if they have been increasing in intensity and frequency. They may also ask if you have any allergies, have a history of head trauma or other underlying health conditions, or take any medications.
- Physical examination: Your doctor may conduct a physical examination, including an examination of your nose, to look for any abnormalities.
- Diagnostic tests: To confirm a diagnosis, your doctor may order tests such as blood tests, EEGs, X-rays of paranasal sinuses, CT scans, or any other investigations as needed. An endoscopy or rhinoscopy may be done in some cases.
How are phantom smells treated?
Treatment of phantom smells primarily depends on the underlying cause.
Some general practices, such as saline nasal rinses, may help get rid of the smells in some people. Doctors may also prescribe numbing medications or steroid nasal sprays as well as vasoconstrictors or drugs that narrow the blood vessels for symptomatic relief.
If your symptoms are caused by an infection or more severe conditions such as Parkinson's disease or epilepsy, the underlying cause needs to be treated accordingly.
In some cases, such as nasal polyps or tumors, surgery may be required.
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