Cacosmia: Definition, Causes, Symptoms And Treatment

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 them. As well as identifying dangerous situations such as a gas leak, or spoiled food that could be eaten if the bad smell were not detected.

However, this sense can be altered for different reasons. These alterations are known as parosmias and encompass all the disorders 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 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 odors 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 going so far as to voluntarily expose themselves to them.

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

Cacosmia belongs to a group of aroma perception conditions called parosmia, which also include hyperosmia, hyposmia and anosmia.

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Diagnosis of cacosmia

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

Another test carried out in the assessment of this alteration is to measure the patient’s olfactory ability. 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 must determine which smells they are.

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 cause should not be underestimated, since one of its functions is to be a first warning sign of danger such as smoke, gas, rotting or spoiled food, etc. .

Likewise, the sense of smell has an essential role in feeding. So a person suffering from cacosmia you may see your eating habits altered since the smell of food also becomes unpleasant.

Causes and treatments

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

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

Brain causes

If possible physical causes are ruled out, it is very possible that cacosmia is produced as a consequence of some brain alteration.

Which would mean that the perceptual alteration is not due to a poor articulation of the senses, but rather to an adulteration of the areas of the brain in charge of managing sensory functions.

Therefore, the possible causes of cacosmia can be:

1. Hypothyroidism

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

In these cases, deficient production of thyroid hormone can trigger both physical and psychological symptoms, and it is common for the sense of smell to also be affected.

2. Epilepsy

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

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 a lack of dopamine can lead to cases of cacosmia

Physical causes

Among the physical causes are 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.

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The main symptoms of sinusitis are rhinorrhea or runny nose, congestion or obstruction of the nasal passages, which causes great difficulty 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 touch

In some types of chronic sinusitis in which infectious agents remain retained in the nasal 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 blockage and mucous secretions.

As with sinusitis, the treatment of rhinitis itself must end the unpleasant sensations. To do 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 has been necessary to relieve symptoms.

3. Postoperative infection

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

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

In either of the two causes, the solution involves reducing the diameter of the nasal cavity and surgically implanting small silicone bars.