Cacosmia: definition, causes, symptoms and treatment

The sense of smell enables humans to detect and process the smells and aromas that surround them. Thanks to this, the person can recognize objects, substances and even people around him. In addition to identifying dangerous situations such as a gas leak or spoiled food that could be eaten if the bad smell was not detected.

However, this meaning can be changed for different reasons. These alterations are known as parosmias and encompass all changes that affect smell, including cacosmia, Which will be discussed throughout this article.

    What is cacosmia?

    Cacosmia is a strange medical condition, the term comes from the Greek and is made up of kakos which translation is “bad” and osme “odor”.

    The term refers to an altered sense of smell in which the brain is unable to properly perceive smells and aromasMore precisely, the person makes you feel unpleasant and even harmful when the rest perceive normal aromas or even do not perceive any odor.

    According to some sources, in some cases, the person may come to feel a certain preference for these unpleasant aromas, or even expose themselves to them on purpose.

    This perceptual change in smell is common in patients with some kind of psychiatric illness or disorder, As well as in people with physical injuries such as epilepsy or deterioration of the nasal cavity.

    Cacosmia belongs to a group of aroma perception disorders called parosmia, which also includes hyperosmia, hypoosmia, and anosmia.

    Diagnosis of cacosmia

    In the diagnosis of cacosmia, as with other parosmias, it is necessary to conduct a physical examination of the ears, nose and throat, to determine the origin of the disease or to exclude that the causes are physical. This analysis is carried out by endoscopy, which consists of inserting, 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 evaluation of this alteration consists in measuring the olfactory capacity of the patient. This determines the minimum amount of aromas that a person is able to perceive. Likewise, a test is also performed in which the patient is exposed to a series of different aromas and the patient has to determine which odors are being treated.

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

    The inconveniences and interference that can be caused by impaired sense of smell should not be underestimated, as one of its functions is to be an early warning sign when faced with a danger such as smoke, gas, decay or bad food, etc. .

    Likewise, smell plays an essential role in nutrition. So a person suffering from cacosmia you can even see your eating habits changed, As the smell of food becomes something equally unpleasant.

    Causes and treatments

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

    They can be differentiated between physical and psychological causes, in which there abnormal activity in certain areas of the brain the causes of this alteration.

    brain causes

    In the case of excluding possible physical causes, it is very possible that cacosmia is produced as a result of a brain disorder.

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

    Therefore, the possible causes of cacosmia can be:

    1. Hypothyroidism

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

    In these cases, low production of thyroid hormones can trigger physical and psychological symptoms, and it is common for smell to be affected as well.

    2. Epilepsy

    Some cases of cacosmia have been reported in temporal lobe epilepsies, which are temporary. The onset of cacosmia occurs with one of the seizures and tends to stick around a week or two later.

      3. Parkinson’s disease

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

      physical causes

      Among the physical causes are the following.

      1. Chronic sinusitis

      Chronic sinusitis is emphysema or inflammation of the paranasal sinuses, resulting from infection with a virus, fungus, or type of bacteria.

      The main symptoms of sinusitis are rhinorrhea or runny nose, congestion or obstruction of the nostrils, 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 result, this also results in a reduction or impaired perception of the senses of taste and even touch.

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

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

      2. Crustal rhinitis

      Cacosmia can also have its origin in crustal rhinitis, also known as Ocena. It is an alteration which acts on the nasal mucosa, Causing sneezing, itching, runny nose and mucous discharge.

      As with sinusitis, the treatment of rhinitis itself should end with unpleasant sensations. This combines the application of nasal washes and the administration of antibiotics. However, more serious cases have been reported in which surgery has been necessary to relieve symptoms.

      3. Postoperative infection

      In this case, cacosmia is derived from a complication or accident of surgery to the nasal cavity in which nasal horns sustain injury or damage.

      Another cause can be caused by the desiccation of the nostrils caused by empty nose syndrome.

      In both cases, the solution is to reduce the diameter of the nasal cavity and the implantation by surgery of small silicone bars.

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