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I have suddenly developed a strange smell in my nostrils…

I have suddenly developed...

I have suddenly developed a strange smell in my nostrils that is confusing. I am 66 and this happened seemingly overnight. I constantly have this smell of something burning, or something burnt. This overrides all other smells, although I can still smell other scents. What could cause this and is it cause for alarm?

Doctor's Assistant: How long have you been dealing with this? Are you having any breathing problems?

It happened about 2 months ago, and I am not experiencing breathing problems.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

Well, I am a medical mess. Rheumatoid Arthritis and all the medications that go with it would be my first assumption of cause, but no meds. have changed in several years

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Answered in 13 hours by:
3/18/2018
drphophalia
Category: Neurology
Satisfied Customers: 37,813
Experience: Regularly deal with musculoskeletal neurology, spinal issues, bowel and bladder dysfunctions etc.
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This seems to be Phantosmia, which means perception of smell without an odor present. Phantosmias have either peripheral or central causation, or a combination of the two. Peripherally, `rogue' neurons or nerve endings that emit abnormal signals to the brain or a loss of inhibitory cells to normally functioning olfactory neurons could be at fault. Centrally an area of hyper-functioning brain cells could generate this odor perception. Clinically, it seems possible that a peripheral trigger from a chemosensory or even trigeminal stimulus could signal a central perception of odor. Careful evaluation of individuals with olfactory distortions suggests evidence for both of these theories. Brain imaging using positron emission tomography (PET) scans of individuals with phantosmia has revealed increased activity in the frontal, insular and temporal regions, which decreased after excision of the olfactory epithelium from the nasal cavity involved.

Tests to evaluate for allergy, diabetes mellitus, thyroid functions, renal and liver function, endocrine function, and nutritional deficiencies may be required to ascertain the cause. An ENT specialist would be the doctor to evaluate it. He would give a test for the smell for the differentiation. If the physician's evaluation, deem necessary, an MRI of the brain and CT scan of the sinuses may be needed in some cases. Olfactory epithelium biopsy is used occasionally to ascertain the cause.

Treatment would be dependent on the cause. Anti allergic medications or antibiotics may be needed for the sinus and polyp issues of the nose. Nutritional deficits will need supplemennts of zinc, vitamin A, or thiamine.

Other remedies include pharmacologic doses of vitamins, topical steroids, and tricyclic antidepressants (for their effect on CSF catecholamines). Zinc sulphate in some cases had helped and can be tried. Many doctors use Gabapentin which has proven beneficial in significant number of patients. One of the easiest things to try is topical nasal saline drops. Alternatively, the daily use of Oxymetazoline HCl nasal drops has also been useful, and generally lasts longer.

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drphophalia
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Satisfied Customers: 37,813
Experience: Regularly deal with musculoskeletal neurology, spinal issues, bowel and bladder dysfunctions etc.
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