Disturbances of olfaction and their causes
1. Big picture
Olfaction is clinically important because smell disturbance may be a simple ENT problem such as rhinitis, but it can also be the first clue to head trauma, basal skull fracture, frontal/olfactory groove tumor, temporal lobe epilepsy, herpes simplex encephalitis, Parkinson disease, or dementia.
For the exam, the key is not to list every rare cause, but to answer three questions:
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What type of smell disturbance is present?
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Is it peripheral/nasal, olfactory nerve/bulb/tract, or cortical/temporal?
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Is there a dangerous cause: trauma with cerebrospinal fluid leak, tumor, encephalitis, seizure, or neurodegeneration?
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