Cacosmia: Definition, Causes, Symptoms And Treatment

This alteration affects the perception of odors, causing it to become abnormal.

Little girl smelling food.

The sense of smell allows humans to detect and process the smells and aromas that surround them. Through this, the person can recognize objects, substances and even people that are around her. As well as identifying dangerous situations such as a gas leak, or food in bad condition that can be eaten if the bad smell is not detected.

However, this sense can be altered for different reasons. These alterations are known as parosmias and encompass all alterations that impair the sense of smell, including cacosmia, which will be discussed throughout this article.

What is cacosmia?

Cacosmia is a strange medical condition whose term comes from the Greek and is formed by kakos whose translation is “bad” and osmé “smell”.

The expression refers to an alteration of the sense of smell in which the brain is unable to correctly perceive smells and aromas, specifically the person reports feeling unpleasant and even stinking odors when the rest perceive normal aromas or even do not perceive any odor .

According to some sources, in some cases the person may feel a certain preference for these unpleasant aromas, even voluntarily exposing themselves to them.

This perceptual alteration of the sense of smell is common in patients suffering from some type of illness or psychiatric disorder, as well as in people with physical damage such as epilepsy or deterioration of the nasal cavities.

Cacosmia belongs to a group of scent-sensing conditions called parosmia, which also include hyperosmia, hyposmia, and anosmia.

Diagnosis of cacosmia

In the diagnosis of cacosmia, as with the rest of parosmia, it is necessary to carry out a physical examination of the ears, nose and throat, to specify the origin of the condition or to rule out that the causes are physical . This analysis is performed by endoscopy, which consists of introducing, for example, into the nose, a thin tube with a small camera, which allows the clinician to view the nasal cavities from the inside.

Another of the tests carried out in the assessment of this alteration is to measure the patient’s olfactory capacity. To do this, the minimum amount of aromas that a person is capable of perceiving is determined. Likewise, a test is also carried out in which the patient is exposed to a series of different aromas and this must determine what odors are treated.

Finally, it is also necessary to review the patient’s medical history, in order to find out if it has been subjected to possible exposures to toxins.

The inconveniences and interferences that an alteration of the sense of smell can produce should not be underestimated, since one of its functions is to be a first warning sign of a danger such as smoke, gas, spoiled or bad food, etc. .

Likewise, the sense of smell plays an essential role in eating. So a person who suffers from cacosmia can see their eating habits altered, since the smell of food becomes something also unpleasant.

Causes and treatments

Cacosmia can be caused by different causes, both physical and psychological. Therefore, the type of treatment of choice will vary depending on the cause of this, hence the importance of making a correct diagnosis and a thorough evaluation.

They can differentiate between physical and psychological causes, in which an abnormal activity of certain brain areas is the cause of this alteration.

Brain causes

In the case of discarding the possible physical causes, it is very possible that the cacosmia is produced as a consequence of some cerebral alteration.

Which would mean that the perceptual alteration is not due to a poor articulation of the sense, but to an adulteration of the areas of the brain responsible for managing sensory functions.

Therefore, the possible causes of cacosmia can be:

1. Hypothyroidism

Hypothyroidism is a disease of the endocrine system, sometimes caused by a malfunction of the immune system, by infections or even during pregnancy.

In these cases, the deficient production of thyroid hormone can trigger both physical and psychological symptoms, and the sense of smell is also frequently affected.

2. Epilepsy

Some cases of cacosmia have been registered in epilepsies of the temporal lobe, these being of a temporary nature. The onset of cacosmia occurs with one of the seizures and tends to persist for a week or two afterward.

3. Parkinson’s disease

Cacosmia is also a symptom seen in some cases of Parkinson’s disease. Although it is not a constant in all patients and the specific cause is not determined, it is theorized that the lack of dopamine can lead to cases of cacosmia.

Physical causes

Physical causes include the following.

1. Chronic sinusitis

Chronic sinusitis consists of emphysema or inflammation of the paranasal sinuses, as a result of an infection by a virus, a fungus or some type of bacteria.

The main symptoms of sinusitis are rhinorrhea or runny nose, congestion or obstruction of the nasal passages, which causes great difficulty in breathing through the nose; It is also characterized by hypersensitivity, pain, and inflammation around the eyes, cheekbones or nose. As a consequence, this also causes a reduction or alteration of the perception of the senses of taste and, even, of touch.

In some types of chronic sinusitis in which infectious agents remain trapped in the sinuses, cacosmia appears as one of the main symptoms.

Being associated with a physical cause, the administration of antibiotic drugs should be sufficient to eradicate the perception of unpleasant odors.

2. Crusted rhinitis

Cacosmia can also find its origin in crusted rhinitis, also called ocena. This is an alteration that acts on the nasal mucosa, causing sneezing, itching, nasal packing and mucous secretions.

As with sinusitis, the treatment of the rhinitis itself must end the unpleasant sensations. For this, the application of nasal washes and the administration of antibiotics are combined. However, more serious cases have been recorded in which the use of surgery to relieve symptoms has been necessary.

3. Postoperative infection

In this case, cacosmia is derived from a complication or setback of a surgery of the nasal cavity in which the nasal horns suffer some injury or damage.

Another cause may be caused by drying out of the nasal passages caused by empty nose syndrome.

In either of the two causes, the solution is to reduce the diameter of the nasal cavity and to implant small silicone rods through surgery.

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