Dear Pharmacist

from 2023-01-28 - The Howell Times

R.C. Shea & Assoc. Inside The Law

Suzy Cohen, R. Ph.

What Causes People To See Or Smell Weird Things

By Suzy Cohen, R. Ph.

The first time I heard of a person smelling something bad that wasn’t actually there was when I worked in long-term care facilities in the 1990s. I knew several patients that would say they smelled “burned rubber” or “mold” or “something rotten” in the room, and asked if I smelled it too. I did not.

Phantosmia is the medical term for the perception of an odor that is not actually present. It is also known as an “olfactory hallucination.” The phantom odor can be perceived as pleasant or unpleasant and can vary in intensity. One possible cause for this is a temporal lobe problem/seizure. Your temporal lobes are on the sides of your head in the area where you get a tension headache. Other possible causes of phantosmia include:

• Upper respiratory infection or sinusitis

• Head injury

• Exposure to certain chemicals or toxins

• Certain medications

• Parkinson’s disease or multiple sclerosis

• Certain types of tumors (olfactory neuroblastoma)

• Olfactory nerve damage or dysfunction

Photopsia is the medical term for the perception of flashing lights or sparks. It can also refer to visual disturbances that resemble flickering or flashing lights. One possible cause for this is a temporal lobe problem/seizure.

Other possible causes of photopsia include:

• Migraine headaches

• Retinal detachment or age-related macular degeneration

• Epilepsy

• Side effects of certain medications

• Vitamin deficiency, especially B12, folate, thiamine, vitamin A

• Alcohol or drug abuse

Temporal lobe seizures can cause both phantosmia and photopsia and this condition is typically treated with medication, specifically anti-epileptic drugs. The most commonly used AEDs for temporal lobe seizures include carbamazepine, topiramate, lamotrigine and phenytoin.

Symptoms of a temporal lobe seizure can include:

• Sensory disturbances, such as a sudden, strange smell or taste

• Déjà vu or hallucinations

• Emotional changes, such as fear or anxiety

• Auditory symptoms, such as hearing noises or voices

• Visual symptoms, such as seeing flashing lights or hallucinations

• A feeling of rising or falling

• Numbness or tingling in the face or body

• Difficulty speaking or understanding speech

• Loss of consciousness or confusion

• Memory loss or confusion after the seizure. Other potential interventions for temporal lobe seizures include cannabidiol (CBD supplements), vagal nerve stimulation, and/or a strict ketogenic diet.

Temporal lobe problems and seizures can go undiagnosed for years. They can cause a variety of symptoms that come and go such as sensory disturbances, mood swings, auditory or visual symptoms, difficulty speaking, confusion, and memory loss.

Temporal lobe seizures are one common cause of symptoms like phantosmia and photopsia. Getting proper treatment for the condition can limit the frequency of episodes that you have. Seeing an ophthalmologist, ENT doctor, and neurologist is important in order to have a complete workup. If you’d like to read the longer more comprehensive version of this article, sign up for my free newsletter at suzycohen.com and I’ll email it to you.

(This information is not intended to treat, cure or diagnose your condition. Suzy Cohen is the author of “The 24-Hour Pharmacist” and “Real Solutions.” For more information, visit www.SuzyCohen.com)