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Olfactory hallucinations have been described since the 19th century as a particular, often unpleasant smell at the beginning or during the spell. The olfactory cortex are involved in temporal lobe epilepsy.
Objectives
The aim was analyze the relationship between the olfactory hallucinations and the previus diagnosis of epilepsy.
Methods
In this study, we present a clinical case and review the current literature showing the relationship between smell and epilepsy.
Results
A 69-years-old woman, with a medical history of epilepsy, went to the emergency department describing a recent episode of seizure, self-limited in time, after a sensation of an unpleasant smell in bed. A medical history of osteoarthritis, cholecystectomy and essential tremor is described. No unknown drug allergies. The neurological examination shows dysarthric speech, tremor in the right upper limb, isochoric and reactive pupils, preserved sensitivity and strength, and a positive Romber’s sign. The physical examination, blood test and vital signs were normal. The head CT scan showed signs of ischemic leukoencephalopathy, without acute ischemic or hemorrhagic lesions. The patient was medicated with 1000 mg of valproate daily, which was suspended a month ago due to an alteration in liver transaminases. Treatment with diazepam 10 mg daily was prescribed and referred for consultation. The sense of smell changes over time for anormal aging process, affecting abilitiesto detect, identify and discriminate odors.Several neurodegenerative diseases presentcertain alterations that help us determine yourorigin and progression (Vaughan and Jackson, 2014).
Conclusions
Olfactory auras occurs before a seizure of the temporal lobe. Repeated stimuli in limbic regions can produce changes in the piriform cortex, with increased excitability and in epileptic discharges.
This chapter reviews the literature on olfactory hallucinations and discerns any characteristics of olfactory hallucinations which allow those of organic aetiology to be distinguished from those of functional origin, such as those related to schizophrenia. Olfactory hallucinations/auras are rare in patients with epilepsy but may be more common when the epilepsy type is restricted to temporal lobe epilepsy (TLE). The prevalence of olfactory hallucinations in psychiatric populations has varied widely. Olfactory hallucinations have been described in patients with differing diagnoses including schizophrenia, affective disorders, eating disorders and hysteria. Olfactory hallucinations are observed in patients with schizophrenia but usually in combination with the other symptoms of schizophrenia and with hallucinations in other modalities. There are no clear-cut qualitative differences between the olfactory hallucinations described by patients with schizophrenia compared to patients with 'organic states', though the presence of continuous olfactory hallucinations is more suggestive of a psychiatric diagnosis.
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