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Anosmia / Loss Of Smell

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Diagnostic evaluation of anosmia begins with a detailed elicitation of history. The doctor asks for important associated symptoms like nasal congestion, rhinorrhoea, or both.

Diagnostic evaluation of anosmia begins with a detailed elicitation of history. The doctor asks for important associated symptoms like nasal congestion, rhinorrhoea, or both. The nature of nasal discharge in rhinorrhoea is important. Relation of anosmia to any upper respiratory infections or head injury is deeply excavated into. A history of sinus disorders; head trauma or surgery; allergies; exposure to drugs; chemicals or fumes is important. Physical examination is done to identify swelling, inflammation, discharge, and polyps. Making the patient breathe through each nostril separately (by manually occluding the other) helps to identify obstruction. Unilateral anosmia is often unrecognised. Test for olfaction is performed. Patient is made to smell pungent odor such as from a vial containing coffee, cinnamon, or tobacco from each nostril separately. This can also help to identify unilateral anosmia.

Psychophysical assessment of odor and taste identification may be performed using commercially available testing kits. One such kit may contain sequential dilutions of an odorous chemical. Kit using a scratch-and-sniff battery of odours is also available.

A nervous system examination may be performed so as to know if any of the cranial nerves are damaged. Diplopia, difficulty speaking or swallowing, tinnitus, vertigo are asked for. A detailed mental status examination is vital, especially in the elderly; Alzheimer’s disease is a common cause for anosmia in them. When the cause is not obvious a CT of the head (including sinuses) or MRI are ordered for.

Anosmia may be part of normal aging. A slowly progressive loss of smell in an elderly patient with no other symptoms or findings may be normal. Anosmia may walk in by the age of 60 or 70. Significant head trauma or toxin exposure results in sudden onset of anosmia. Progressive confusion and recent memory loss point to Alzheimer’s disease in the elderly. Neurodegenerative diseases such as multiple sclerosis are suspected in cases with waxing and waning neurologic symptoms.

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I'm not sure if it's just my constant allergies but I seem to have on and off issues with smell throughout my life... Thanks for the info I'm going to discuss this with my doctor.
med705 Sunday, August 2, 2015
I'm 46 year old white male and as far back as I can remember I have not had a sense of smell. Sometimes I'm grateful I don't but most of the time I really wish I did. I work in Law Enforcement and it is a sense that would really come in useful most of the time. I don't have a loss of apatite. I am more drawn to sweet foods than most other types of foods. I had an extreme case of chicken pox as a kid...far worse than most people. As a matter of fact the Doctors in the emergency room I went to took pictures of me because they had not seen a case as severe as mine. I have had severe sinusitis as a young adult 25-33. I had surgery that opened up all my sinuses and removed some huge polyps be hind my right eye. I was getting horrible head aches as a result of my chronic sinus problems. Since that time I haven't had anymore problems. I used to smoke for about 14 or so years but have not smoked for about 15-16 years. I would love to be able to smell my wife's perfume, her cooking, or on the job I'd love to be able to detect the smell of alcohol and drugs. Is there any hope of gaining a sense of smell? Where would I go to get answers>
Boog Sunday, July 13, 2014
I am a 32-year-old male who has been suffering from anosmia for the past 10 years. Initially, I had sinusitis problems and has been undergoing different kinds of treatments without any significant relief. one of those was the ayurvedic treatment of nasya for approximately 10 days, which made my life a hell, where I lost my smell and consulted an ENT and was told was due to mucus infection and had undergone again various treatments resulting in polypoidectomy too, but everything was in vain. Ultimately, these treatments have provided nothing, but depression, a life without taste, smell, nothing more than a hell, it just continues. Right now, I am undergoing homeopathic treatment, but that too without any success. It should be noted that once in a while, for a fraction of second, I do get smell, and it vanishes for ever. Please may I know kindly if there is any remedy for me to regain my smell and taste back, so that my life will be of some meaning to me. Please do guide me as to which physician I need to consult. Of note, I had CT scan about 5 years ago, which did not reveal anything of significance.
pppdha Monday, June 30, 2014
A patient with complete anosmia wil still respond to inhalation of; 1. coffee 2. ammonia 3. vanilla 4. garlic
goharpearl Thursday, July 18, 2013
I also have the problem of getting the right smell especially during winters! I have consulted a few doctors, but my situation haven't improved much. Can anyone suggest remedies for this problem of mine?
Advancells Tuesday, July 30, 2013
are you sure? I have anosmia and I can't sense coffee. My friend tested me. And ammonia, as in when you let your pee sit in the toilet without flushing? Yea, I definitely can't smell that. Docs tested me with an alcohol pad too and I couldn't identify that, so wherever you're getting your information, please review it's authenticity
Guest Wednesday, August 19, 2015
I could never smell as long as I remember..does anyone else have this same issue? I guess being born not able to smell. I've been reading that people had smell but lost it due to a sickness or medicines. etc. thanks
babeyorange Tuesday, April 2, 2013
I have a cold problem, DNS, and sinusitis from 14 years old and now I am 26. I did't get smell for 7 years. At first it came back time to time and then again lose, but now it permanently gone. I didn't take any antibiotics but treated some medicine like, antazole, rhinozole, alactrol, flunospray e.t.c. I didn't take medicine for 3 years also. What can I do now?
Fair_512 Tuesday, April 2, 2013
Hi suggest you to do yoga there are many poses in yoga to help you.
giri Friday, June 22, 2012
hi im 20 yr old now,im suffering from anosmia is there any reason behind it for causing in early age? is there any problem for brain ??? if there then please answer me i'll definitely consult a doctor
rajeshladi Friday, June 8, 2012
Hi. I'm a 21 year-old male. I suffered from flu-like disease a week ago. I never sought a doctor since the fever and lethargy subsided after 2 days of rest, increased fluid intake, vitamins, and self-medication of over-the-counter fever and colds drugs. So, after like 4 days, my fever was totally gone, my activity tolerance went back to normal, but my colds is still present. So I continued to take medicine for it. After a week, my colds is still present but not that severe. But, I have this loss of sense of taste and smell. At first, I thought it was just brought about by the colds, but this time, I have this phantom smell, and I can't explain it, like it's in between the smell of a freshly-cut lumber and a canned biscuits. I really am worried, since I lost my appetite, and I can't detect whether a food is already spoiled or our help already sprayed insecticide. Please help me. I'm a registered but unemployed nurse. I can comprehend complex medical terms. Please, help me. It really affects my daily activities.
chris08 Friday, April 13, 2012
Is your smell back yet? I had the same progression you described. Lost my smell for over a year while experiencing horrible phantom smells and distasteful foods. If you are still affected, Please check out my previous posts for my successful journey back to most smells and delicious foods again. Best of luck
Traci Tuesday, April 2, 2013
During a 4-week hospitalisation [loss of a kidney due to cancer] 5 years ago, I had an abdominal drain in place (via the nose) for 2 weeks plus. After this I was aware of a constant antiseptic smell and when this faded after 6 months, virtually no sense of smell at all. I also have constant stuffy nose. I do pick up occasional scents if they are very strong and sometimes detect things which don't smell right (eg. coffee doesn't smell like coffee). My GP points to nasal tract infection and says they are virtually impossible to eradicate (I only have 30% of one kidney and some medications are a no-no). Now starting to suffer loss of hearing - which might be linked via sinuses? Any advice or help would be really welcome.
SoloKid Friday, February 24, 2012
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