Table of ContentsView AllTable of ContentsDefinitionSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Definition
Symptoms
Causes
Diagnosis
Treatment
Phantosmia, also known as an olfactory hallucination or “phantom smells,” occurs when you smell odors that are not there. The perceived odors may be constant or come and go. The most common include cigarette smoke, gas, or odors described as metallic, rotten, stinky, fruity, or musty,
There are many possible causes of phantosmia, including simple upper respiratory infections that impairolfaction(smelling). Chronic neurological conditions like epilepsy, migraines, or Alzheimer’s disease can also disrupt these neural pathways.
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What Does Phantosmia Mean?
Phantosmia is a type of smell distortion that falls under the larger umbrella ofdysosmia(dys-meaning abnormal and -osmiameaning smell). Dysosmia refers to a change in your perception of smell, of which there are two types:
Otherolfactory disordersthat affect the sense of smell includehyposmia(a reduced sense of smell) andanosmia(the total loss of smell).
What Types of Smells Does Phantosmia Cause?
Individuals with phantosmia are more likely to report smelling unpleasant odors rather than pleasant ones. Common scents associated with phantosmia include:
Phantosmia Causes
The underlying mechanism of phantosmia is the disruption of theolfactory system.
The causes of this can be broadly categorized as being either peripheral, central, psychiatric, or pharmaceutical. Many cases are alsoidiopathic, meaning of unknown origin.
Peripheral Causes
Phantosmia can occur when olfactory neurons malfunction and send the wrong signals to the brain.Inflammationof the olfactory epithelium is thought to be the main cause, due to conditions like:
Studies suggest that sinus and nasal conditions account for 52% to 72% of all olfactory disorders. Generally speaking, the greater the infection or inflammation, the greater the olfactory disturbance.
Central Causes
The central olfactory system is comprised of organs within the central nervous system that translate signals from the peripheral olfactory system. Central to this is the olfactory bulb which receives nerve signals from the nose and the olfactory cortex comprised of:
Many conditions can directly or indirectly disrupt these structures, leading to phantosmia. These include transient neurological conditions, progressive neurodegenerative disorders, and even hormonal disorders that disruptneurotransmittersthat enable nerve transmission.
Examples include:
Psychiatric Causes
Acetylcholine and norepinephrine, known to be important modulators of smell memory, may inadvertently “unlock” these memories when levels are excessively high or low.
Mental disorders that can cause phantosmia include:
Pharmaceutical Causes
Medication side effects are responsible for about 12% of all olfactory disorders.Fortunately, these side effects are usually reversible once the medication is stopped.
Medicines that may lead to phantosmia include:
How Phantosmia Is Diagnosed
To diagnose phantosmia, your healthcare provider will take a detailed history and perform a physical exam.
It may be helpful to take notes before your appointment. Write down how long you have been experiencing problems with smell and any other present symptoms. Tell your practitioner if you have recently experienced any trauma to the head or nose.
Other screening tools include:
Phantosmia Treatment
Treatment for phantosmia varies depending on the underlying cause. Possible treatment options include:
When to See a Healthcare Provider
Summary
Phantosmia is a condition that causes you to smell odors that are not there. Phantosmia has several possible causes, including inflamed sinuses, upper respiratory infection, head injury, brain tumor, medication side effects, and Parkinson’s disease. Mood disorders and schizophrenia can also involve “phantom smells.”
Your healthcare provider may recommend a physical exam, a smell test, and imaging studies to diagnose phantosmia. Possible treatment options include observation, medications, and surgery.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Altundag A.Parosmia and phantosmia: managing quality disorders.Curr Otorhinolaryngol Rep.2023;11(1):19–26. doi:10.1007/s40136-023-00441-wPellegrino R, Mainland JD, Kelly CE, Parker JK, Hummel T.Prevalence and correlates of parosmia and phantosmia among smell disorders.Chem Senses. 2021 Jan 1;46:bjab046. doi:10.1093/chemse/bjab046Lie G, Wilson A, Campion T, et al.What’s that smell? A pictorial review of the olfactory pathways and imaging assessment of the myriad pathologies that can affect them.Insights Imaging,2021;12:7. doi:10.1186/s13244-020-00951-xJiang X, Yuan Y, Li Z, Ou Y, Li Z.First-episode olfactory hallucination in a patient with anxiety disorder: a case report.Front Psychiatry.2022;13:990341. doi:10.3389/fpsyt.2022.990341Saltagi MZ, Rabbani CC, Ting JY, Higgins TS.Management of long-lasting phantosmia: a systematic review.Int Forum Allergy Rhinol. 2018 Jul;8(7):790-796. doi:10.1002/alr.22108Additional ReadingAjmani GS, Suh HH, Pinto JM.Effects of Ambient Air Pollution Exposure on Olfaction: A Review.Environ Health Perspect. 2016 Nov;124(11):1683-1693. doi:10.1289/EHP136Henkin RI, Potolicchio SJ, Levy LM.Olfactory Hallucinations without Clinical Motor Activity: A Comparison of Unirhinal with Birhinal Phantosmia.Brain Sci. 2013 Nov 15;3(4):1483-553. doi:10.3390/brainsci3041483Kong X, Wang Y, Liu S, Lu Z, Wu H, Mao X, Cheng X, Gao J, Guan J, Yang Y, Li Y, Xing B, Ma W, Wang R.Dysphasia and phantosmia as first presentation of multifocal cerebral anaplastic astrocytomas: case report and review of the literatures.Medicine (Baltimore). 2015 May;94(20):e877. doi:10.1097/MD.0000000000000877
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Altundag A.Parosmia and phantosmia: managing quality disorders.Curr Otorhinolaryngol Rep.2023;11(1):19–26. doi:10.1007/s40136-023-00441-wPellegrino R, Mainland JD, Kelly CE, Parker JK, Hummel T.Prevalence and correlates of parosmia and phantosmia among smell disorders.Chem Senses. 2021 Jan 1;46:bjab046. doi:10.1093/chemse/bjab046Lie G, Wilson A, Campion T, et al.What’s that smell? A pictorial review of the olfactory pathways and imaging assessment of the myriad pathologies that can affect them.Insights Imaging,2021;12:7. doi:10.1186/s13244-020-00951-xJiang X, Yuan Y, Li Z, Ou Y, Li Z.First-episode olfactory hallucination in a patient with anxiety disorder: a case report.Front Psychiatry.2022;13:990341. doi:10.3389/fpsyt.2022.990341Saltagi MZ, Rabbani CC, Ting JY, Higgins TS.Management of long-lasting phantosmia: a systematic review.Int Forum Allergy Rhinol. 2018 Jul;8(7):790-796. doi:10.1002/alr.22108Additional ReadingAjmani GS, Suh HH, Pinto JM.Effects of Ambient Air Pollution Exposure on Olfaction: A Review.Environ Health Perspect. 2016 Nov;124(11):1683-1693. doi:10.1289/EHP136Henkin RI, Potolicchio SJ, Levy LM.Olfactory Hallucinations without Clinical Motor Activity: A Comparison of Unirhinal with Birhinal Phantosmia.Brain Sci. 2013 Nov 15;3(4):1483-553. doi:10.3390/brainsci3041483Kong X, Wang Y, Liu S, Lu Z, Wu H, Mao X, Cheng X, Gao J, Guan J, Yang Y, Li Y, Xing B, Ma W, Wang R.Dysphasia and phantosmia as first presentation of multifocal cerebral anaplastic astrocytomas: case report and review of the literatures.Medicine (Baltimore). 2015 May;94(20):e877. doi:10.1097/MD.0000000000000877
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Altundag A.Parosmia and phantosmia: managing quality disorders.Curr Otorhinolaryngol Rep.2023;11(1):19–26. doi:10.1007/s40136-023-00441-wPellegrino R, Mainland JD, Kelly CE, Parker JK, Hummel T.Prevalence and correlates of parosmia and phantosmia among smell disorders.Chem Senses. 2021 Jan 1;46:bjab046. doi:10.1093/chemse/bjab046Lie G, Wilson A, Campion T, et al.What’s that smell? A pictorial review of the olfactory pathways and imaging assessment of the myriad pathologies that can affect them.Insights Imaging,2021;12:7. doi:10.1186/s13244-020-00951-xJiang X, Yuan Y, Li Z, Ou Y, Li Z.First-episode olfactory hallucination in a patient with anxiety disorder: a case report.Front Psychiatry.2022;13:990341. doi:10.3389/fpsyt.2022.990341Saltagi MZ, Rabbani CC, Ting JY, Higgins TS.Management of long-lasting phantosmia: a systematic review.Int Forum Allergy Rhinol. 2018 Jul;8(7):790-796. doi:10.1002/alr.22108
Altundag A.Parosmia and phantosmia: managing quality disorders.Curr Otorhinolaryngol Rep.2023;11(1):19–26. doi:10.1007/s40136-023-00441-w
Pellegrino R, Mainland JD, Kelly CE, Parker JK, Hummel T.Prevalence and correlates of parosmia and phantosmia among smell disorders.Chem Senses. 2021 Jan 1;46:bjab046. doi:10.1093/chemse/bjab046
Lie G, Wilson A, Campion T, et al.What’s that smell? A pictorial review of the olfactory pathways and imaging assessment of the myriad pathologies that can affect them.Insights Imaging,2021;12:7. doi:10.1186/s13244-020-00951-x
Jiang X, Yuan Y, Li Z, Ou Y, Li Z.First-episode olfactory hallucination in a patient with anxiety disorder: a case report.Front Psychiatry.2022;13:990341. doi:10.3389/fpsyt.2022.990341
Saltagi MZ, Rabbani CC, Ting JY, Higgins TS.Management of long-lasting phantosmia: a systematic review.Int Forum Allergy Rhinol. 2018 Jul;8(7):790-796. doi:10.1002/alr.22108
Ajmani GS, Suh HH, Pinto JM.Effects of Ambient Air Pollution Exposure on Olfaction: A Review.Environ Health Perspect. 2016 Nov;124(11):1683-1693. doi:10.1289/EHP136Henkin RI, Potolicchio SJ, Levy LM.Olfactory Hallucinations without Clinical Motor Activity: A Comparison of Unirhinal with Birhinal Phantosmia.Brain Sci. 2013 Nov 15;3(4):1483-553. doi:10.3390/brainsci3041483Kong X, Wang Y, Liu S, Lu Z, Wu H, Mao X, Cheng X, Gao J, Guan J, Yang Y, Li Y, Xing B, Ma W, Wang R.Dysphasia and phantosmia as first presentation of multifocal cerebral anaplastic astrocytomas: case report and review of the literatures.Medicine (Baltimore). 2015 May;94(20):e877. doi:10.1097/MD.0000000000000877
Ajmani GS, Suh HH, Pinto JM.Effects of Ambient Air Pollution Exposure on Olfaction: A Review.Environ Health Perspect. 2016 Nov;124(11):1683-1693. doi:10.1289/EHP136
Henkin RI, Potolicchio SJ, Levy LM.Olfactory Hallucinations without Clinical Motor Activity: A Comparison of Unirhinal with Birhinal Phantosmia.Brain Sci. 2013 Nov 15;3(4):1483-553. doi:10.3390/brainsci3041483
Kong X, Wang Y, Liu S, Lu Z, Wu H, Mao X, Cheng X, Gao J, Guan J, Yang Y, Li Y, Xing B, Ma W, Wang R.Dysphasia and phantosmia as first presentation of multifocal cerebral anaplastic astrocytomas: case report and review of the literatures.Medicine (Baltimore). 2015 May;94(20):e877. doi:10.1097/MD.0000000000000877
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