What is phantosmia and what causes it?

What is phantosmia?

Phantosmia is an olfactory hallucination, in which the patient falsely perceives odors that are not present in the surrounding environment, affecting their quality of life. (1)

Note: Phantosmia should not be confused with parosmia, which is another disorder in the perception of odor that is present in the environment, only that it is distorted.

In itself, phantosmia isan olfactory alteration, which is characterized mainly because the patient describes phantom odors, where the person is fully aware that the olfactory stimuli are not real when realizing that the source is nonexistent.

What causes phantosmia?

Olfactory hallucinations occur due to the presence of several risk factors, among which we can name:

1. Infections and nasal polyps

Infections in the respiratory tract, especially in the nasal passages or the appearance of nasal polyps(2), can cause a problem such as loss or alteration of the sense of smell.

In this case, the functioning of the olfactory epithelium or the olfactory receptor neurons is altered, which can cause the appearance of olfactory disorders such as phantosmia.

2. Brain injuries

is responsible for processing the different olfactory stimuli.

This situation can cause an alteration in how odors are perceived and even perceive the presence of some pleasant or unpleasant odor, where the source that should originate it is not present.

You should know: Phantasmia may be present in patients with episodes of Delusion or paranoia .

3. Exposure to chemicals

People who are constantly exposed to chemical products, which emit gases and vapors that can irritate and even damage the structures of the olfactory apparatus, may present distortions in the perception of odors.

Note: This prolonged exposure to irritating substances of the olfactory mucosa causes chronic and even irreversible damage to the olfactory receptors where the neurons, the olfactory bulb and the structures that make up the paranasal sinuses are located, causing phantosmia, among other conditions.

4. Migraines and epilepsy

When there is a problem in the brain receptors, a condition called central phantosmia occurs , which represents a greater health risk since it can be linked to other problems such as migraine with aura (4) It has been described that a phantosmia precedes migraine.

and which can also be maintained during seizures, such as phantosmia.

To highlight: Phantasmia can occur in some types of hallucinations such as hypnagogic and hypnopompic .

5. Smoking

Smoking undeniably damages the olfactory receptor organs located in the nasal cavity, deteriorating chronically and causing conditions such as rhinitis,  sinusitis , even polyps and nasal tumors.

You should know: This deterioration in the olfactory receptors causes the inability to recognize odors , often resulting in confusion between what is perceived and what really exists or simply the capture of odors that are not present in the environment.

6. Radiation for cancer treatment

How to remove phantosmia?

As has been seen, phantosmia arises due to a series of organic anomalies and the strategies to eliminate it are aimed at the pathologies that originate it , which we mention below:

1. Treatment of underlying disease

In the above context, it is imperative that the treating physician determine the real cause of the patient’s phantosmia and thereby develop the appropriate strategy or strategies aimed at improving the pathology that causes the olfactory hallucination.

2. Saline Nasal Rinses

When the reason for the phantosmia is found in a condition that occurs to the olfactory receptors located on the periphery of the olfactory apparatus, one of the solutions is the use of saline solution in the form of a rinse to decongest and clean the pathway that the molecules travel. Laden with odours.

3. Sprays and nose drops

4. Prescription drugs

Medications prescribed by a medical specialist such as an otolaryngologist or a neurologist can also help treat the pathologies caused by phantosmia.

Among them, antipsychotic, antimigraine and anticonvulsant or transcendental stimulation medications can be used depending on each particular case.

Note: It is important that the patient or their relatives provide all the necessary information, so that their doctor can make a correct diagnosis and use the appropriate pharmacological strategy.

Key Conclusions

• Phantasmia is an olfactory hallucination, in which the patient falsely perceives odors that are not present in the surrounding environment.
• This condition gives the false sensation of perceiving pleasant and/or unpleasant odors   through one or both nostrils.
• In fantasmia, the patient is aware of what is happening to him, realizing that the source is non-existent.
• Phantasmia can be treated with various strategies depending on the cause, such as prescription drugs, sprays, rinses, and nose drops.