Loss of smell is known as
anosmia. Anosmia can occur on both sides or a single side. Olfactory problems can be divided into different types based on their malfunction. The olfactory dysfunction can be total (
anosmia), incomplete (partial anosmia,
hyposmia, or microsmia), distorted (
dysosmia), or can be characterized by spontaneous sensations like
phantosmia. An inability to recognize odors despite a normally functioning olfactory system is termed olfactory
agnosia.
Hyperosmia is a rare condition typified by an abnormally heightened sense of smell. Like vision and hearing, the olfactory problems can be bilateral or unilateral meaning if a person has anosmia on the right side of the nose but not the left, it is a unilateral right anosmia. On the other hand, if it is on both sides of the nose it is called bilateral anosmia or total anosmia. Destruction to olfactory bulb, tract, and primary cortex (
brodmann area 34) results in anosmia on the same side as the destruction. Also, irritative lesion of the
uncus results in olfactory hallucinations. Damage to the olfactory system can occur by
traumatic brain injury,
cancer, infection, inhalation of toxic fumes, or neurodegenerative diseases such as
Parkinson's disease and
Alzheimer's disease. These conditions can cause
anosmia. In contrast, recent finding suggested the molecular aspects of olfactory dysfunction can be recognized as a hallmark of amyloidogenesis-related diseases and there may even be a causal link through the disruption of multivalent metal ion transport and storage. Doctors can detect damage to the olfactory system by presenting the patient with odors via a scratch and sniff card or by having the patient close their eyes and try to identify commonly available odors like coffee or peppermint candy. Doctors must exclude other diseases that inhibit or eliminate 'the sense of smell' such as chronic colds or sinusitis before making the diagnosis that there is permanent damage to the olfactory system. Prevalence of olfactory dysfunction in the general US population was assessed by questionnaire and examination in a national health survey in 2012–2014. Among over a thousand persons aged 40 years and older, 12.0% reported a problem with smell in the past 12 months and 12.4% had olfactory dysfunction on examination. Prevalence rose from 4.2% at age 40–49 to 39.4% at 80 years and older and was higher in men than women, in blacks and Mexican Americans than in whites and in less than more educated. Of concern for safety, 20% of persons aged 70 and older were unable to identify smoke and 31%, natural gas.
Causes of olfactory dysfunction '
Fabrica, 1543.
Human Olfactory bulbs and Olfactory tracts outlined in red The olfactory system is a vital sense, and its dysfunction may lead to a reduced quality of life, an inability to determine hazardous odors, decreased pleasure in eating, and poor mental health. The common causes of olfactory dysfunction include advanced age, viral infections, exposure to toxic chemicals, head trauma, and neurodegenerative diseases. The basis for age-related changes in smell function include closure of the cribriform plate, Most viral infections are unrecognizable because they are so mild or entirely
asymptomatic.
Exposure to toxic chemicals Chronic exposure to some airborne toxins such as
herbicides,
pesticides,
solvents, and heavy metals (cadmium, chromium, nickel, and manganese), can alter the ability to smell. These agents not only damage the olfactory epithelium, but they are likely to enter the brain via the olfactory mucosa.
Head trauma Trauma-related olfactory dysfunction depends on the severity of the trauma and whether strong acceleration/deceleration of the head occurred. Occipital and side impact causes more damage to the olfactory system than frontal impact. However, recent evidence from individuals with traumatic brain injury suggests that smell loss can occur with changes in brain function outside of olfactory cortex.
Neurodegenerative diseases Neurologists have observed that olfactory dysfunction is a cardinal feature of several neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease. Most of these patients are unaware of an olfactory deficit until after testing where 85% to 90% of early-stage patients showed decreased activity in central odor processing structures. Other neurodegenerative diseases that affect olfactory dysfunction include Huntington's disease, multi-infarct dementia, amyotrophic lateral sclerosis, and schizophrenia. These diseases have more moderate effects on the olfactory system than Alzheimer's or Parkinson's diseases. Furthermore, progressive supranuclear palsy and parkinsonism are associated with only minor olfactory problems. These findings have led to the suggestion that olfactory testing may help in the diagnosis of several different neurodegenerative diseases. Neurodegenerative diseases with well-established genetic determinants are also associated with olfactory dysfunction. Such dysfunction, for example, is found in patients with familial Parkinson's disease and those with Down syndrome. Further studies have concluded that the olfactory loss may be associated with intellectual disability, rather than any Alzheimer's disease-like pathology. Huntington's disease is also associated with problems in odor identification, detection, discrimination, and memory. The problem is prevalent once the phenotypic elements of the disorder appear, although it is unknown how far in advance the olfactory loss precedes the phenotypic expression. ==History==