Idiopathic Phantosmia: Outcome and Clinical Significance

Abstract

Background/Aim: Little is known about the clinical significance of phantosmia. The literature on phantosmia indicates that this symptom has a wide range of differential diagnoses. However, most cases of phantosmia remain of unknown origin. Our goal was to follow up patients with idiopathic phantosmia, with special regard to improvement rates and possible severe health conditions preceded by phantosmia of unknown origin. Methods: Forty-four patients with idiopathic phantosmia which had consulted our Ear-Nose-Throat Smell and Taste Clinic over the last 10 years were contacted by telephone and underwent a structured medical interview. Results: None of the patients had developed any severe health condition or Parkinson’s disease. More than 5 years after the occurrence of phantosmia, more than 50% of the patients experienced disappearance (31.8%) or improvement (25%). In the remaining cases, phantosmia did not change (38.7%) or became worse (<5%). Conclusion: The main findings of the present study were that idiopathic phantosmia improves or disappears in almost two thirds of the patients after more than 5 years, and that idiopathic phantosmia seems to be more likely a harmless symptom rather than a reliable predictor of early Parkinson’s disease or other severe diseases.

Smell and Taste in Inflammatory Bowel Disease

“…Reden et al [57] did, however, show that phantosmia has no prognostic significance in patients suffering from olfactory dysfunctions. In addition, Landis et al [58] concluded that idiopathic phantosmia does not seem to be a reliable predictor of severe disease.…”

Management of long‐lasting phantosmia: a systematic review

“…Endpoints were primarily based on subjective patient responses. Management options included observation and medical and surgical therapy. No studies that met the inclusion criteria addressed the role of steroid therapy, and this may be the subject of future studies.…”

“…One article provided outcomes with observation alone, with 56.8% of patients reporting short‐term improvement of symptoms but only 31.8% of patients reporting long‐term relief (Table ). Twenty‐four patients were treated medically with antipsychotic medications, antiseizure medications, topical cocaine, or antimigraine prophylactic medications .…”

“…Twenty‐four patients were treated medically with antipsychotic medications, antiseizure medications, topical cocaine, or antimigraine prophylactic medications . Long‐term symptomatic relief was achieved with antiseizure and antipsychotic medications in 4 of 4 patients, but none of the 6 patients treated with topical cocaine application had long‐term resolution of their symptoms (Table ) . One study retrospectively investigating migraine patients with phantosmia linked to their headaches showed that 9 of 14 patients had improvement in their symptoms with antimigraine prophylactic therapy including topiramate, nortriptyline, and verapamil, and no patient had resolution of their headaches without a corresponding resolution of their phantosmia symptoms .…”

Olfactory Hallucinations without Clinical Motor Activity: A Comparison of Unirhinal with Birhinal Phantosmia

“…One group of investigators reported that what they described as “idiopathic phantosmia” disappeared spontaneously after the symptoms were present for a period of more than five years [123]. …”