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Phantosmia is the bizarre phenomenon of smelling things that simply aren't there. Why would your nose play tricks on you, and what are the treatment options?

More Serious Causes Of Phantosmia

Phantosmia can have more serous causes as well. Epilepsy "is one of the systemic conditions that have been closely related to the occurrence of phantosmia", according to Dr Gupta. "The epilepsy may be limited in its severity and often times an altered sensation of smell may be the only real clinically apparent cause." Long-term management with anti-epileptic drugs is the key to keeping this under control, along with identification of personal triggers.

Certain types of brain tumors can also cause olfactory hallucinations: "A malignant tumor in the section of the brain that is responsible for interpreting the signals sent back from the olfactory nerve can cause a constant smell of smoke or something else. This could be an extremely serious sign and may require immediate treatment if present. Doctors will usually advise multiple scans to double and triple check any positive findings." 

Anosmia, a loss of the ability to perceive smells, can also actually be responsible for abnormal and phantom smells being. That may seem counter-intuitive, but Dr Gupta says: "Doctors have hypothesized that this is due to an over-compensation of the nerve as well as the olfactory center inside the brain." He adds that treatment depends on identifying the root cause of the loss of smell. Once again, a great number of factors can be responsible, so some detective work may be necessary. 

Stroke, chemotherapy, and exposure to dangerous chemicals such as certain pesticides can also lead to phantosmia. Parkinson's Disease, Alzheimer's, and physical head injuries are other possible causes of smelling things that are not there. 

Diagnosis And Treatment

Do you suspect you smell things that aren't there, because others say they don't smell what you smell? The long and varied list of possible causes should convince you that this experience is definitely worth a trip to the doctor. The first diagnostic step will be to find out if the smell is real or perceived. The next steps will include figuring out if your sense of smell is the problem, or if your sense of taste is affected. 

Obvious causes like nasal polyps, head injuries, and sinus infections will be ruled out first. If the cause is not clear after that, a nasal endoscopy, MRI scan, or CT scan are the next likely diagnostic steps. 

The treatment plan will obviously depend on the cause of the problem, as always. Sinusitis will just go away, for example, and if that is the underlying cause of your phantosmia, recovery is the answer. Persistent olfactory hallucinations may be treated with nasal drops, saline rinses, sedatives, anti-epileptic drugs, or even antidepressants. In some cases, fixing the underlying problem with surgery is the ultimate answer.

That wasn't very helpful, was it? It does illustrate that this is a condition that absolutely requires the attention of a medical professional. Do not ignore this if it sounds familiar to you, because your nasal trickery may be the red flag that you have a serious problem — in which case you can probably benefit from early treatment. And if it turns out to be a dental problem or sinusitis, you'll be able to rest assured knowing that you don't have a brain tumor!