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April 2009

Parkinsonism: The Hyposmia and Phantosmia Connection

Arch Neurol. 2009;66(4):538-542. doi:10.1001/archneurol.2009.38

A potentially important association of phantosmias and Parkinson disease (PD) has been de lineated by Landis and Burkhard.1 We extend their description of 2 patients to an additional patient who similarly had phantosmias, parkinsonism, and hyposmia.

A 64-year-old, right-handed, white man with a history of chronic hemochromatosis (phlebotomy treated) for the last 1.5 years had olfactory hallucinations of a smoky, burnt-wood smell that was mildly unpleasant, of fluctuating intensity, and occurring intermittently every other day for hours in duration. When it increased in intensity, the sensation became more unpleasant with a superimposed onion and gasoline sweet smell associated with lacrimation. The phantosmia was reduced by holding his breath, smelling strong odors, eating, distraction, nasal irrigation, sleep, blowing the nose, laughing, humming, and talking. It was present on both inhalation and expiration, and it persisted if either nostril (but not both) was occluded.

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