Content area
Full text
A 71-year-old woman awoke one morning to find that she perceived all aromas, odors, and fragrances as smelling like burnt toast. Over the next three years, numerous studies and therapeutic trials failed to elicit the cause of her dysosmia or to provide relief. Finally, the demonstration of small infarcts as seen on a brain MRI suggested that an infarct near the olfactory pathway was responsible for the sudden onset and the 11 year persistence of her unique paromia.
A 71-year-old woman awoke one morning smelling smoke, but no smoke was found. As the day progressed, she realized that all aromas, odors, and fragrances smelled like burnt toast. This perception has continued, seriously interfering with her enjoyment of foods and leading gradually to a 25-pound weight loss. Her sense of taste has remained intact.
Her general health has been good, with her only medications being occasional naproxen and chlordiazepoxide. A neurologic examination, general physical examination, and extensive examinations of her nose, throat, teeth, and ears showed normal results. Blood studies were also normal, including a serologic test for syphilis, thyroid scan, and serum immunoglobulin E. Her electrocardiogram results were normal, as were sinus roentgenograms, and a computed tomography scan. An electroencephalogram, with and without challenge with pungent odors (coffee...