Loss of the Sense of the Smell Often Precedes the Major Symptoms of Alezheimer Disease And…?

One Comment

1. Mags says:

   March 11, 2011 at 4:05 pm

   First of all, the loss of the sense of smell, ansomia, occurs during Alzheimer’s, it is usually not a precursor symptom as it can be in Parkinson’s disease. There might be some instances where it precedes AD, but the medical inclination would be to look at other conditions, especially PD.

   When it is found, it is important that the patient list every symptom they have noticed no matter how unrelated they may seem. Since the blood test for PD has not reached the market yet and there are no other tests to quantify the disease, it would be important to refer the patient to a neurologist who specializes in motion disorders despite the fact that ansomia is a non-motor symptom of PD.

   Anosmia itself can have several causes and related conditions. That symptom alone is not enough to direct attention to PD but with what is known now, it should be AFTER ruling out other conditions:
   http://www.wrongdiagnosis.com/symptoms/anosmia/book-causes-8a.htm
   From the site above:
   “Begin the patient history by asking about the onset and duration of anosmia and related signs and symptoms—stuffy nose, nasal discharge or bleeding, postnasal drip, sneezing, dry or sore mouth and throat, loss of sense of taste or appetite, excessive tearing, and facial or eye pain. Pinpoint any history of nasal disease, allergies, or head trauma. Ask about heavy smoking and the use of prescribed or over-the-counter nose drops or nasal sprays. Be sure to rule out cocaine use.

   Inspect and palpate nasal structures for obvious injury, inflammation, deformities, and septal deviation or perforation. Observe the contour and color of the nasal mucosa and the size and color of the turbinates. Check for polyps, which appear as translucent white masses around the middle meatus. Note the source and character of any nasal discharge. Palpate the sinus areas for tenderness and contour.
   Assess the patient for nasal obstruction by occluding one nostril at a time with your thumb as the patient breathes quietly; listen for breath sounds and for sounds of moisture or mucus. Test olfactory nerve (cranial nerve I) function by having the patient identify common odors.”

   As the medical profession as a whole begins to think outside the box until it becomes inside the box and has specific testing procedures for PD, it is partly up to the patient not to accept “well it isn’t this” without finding out what “it” is.

   From Wrong Diagnosis.com are questions which the medical team should be asking:
   ANOSMIA OR UNUSUAL ODORS: Ask the following questions:
   (Algorithmic Diagnosis of Symptoms and Signs)

   1.Is it acute or chronic? Acute loss of smell would certainly suggest an acute upper respiratory infection (URI). It would also suggest recent exposure to toxic fumes or recent head injury. If the anosmia or unusual odor is intermittent, then one should consider psychomotor epilepsy.
   2.Is there a history of trauma? A skull fracture, particularly if it involves the cribriform plate, may interrupt the olfactory nerves and cause anosmia.
   3.Is there a history of drug use or overuse of nasal sprays? Captopril and penicillamine may cause anosmia. Overuse of alcohol or tobacco may also be the problem. Anti-rheumatic and antiproliferative drugs are also known to cause anosmia.
   4.Is the anosmia unilateral or bilateral? If there is unilateral anosmia, one should consider an olfactory groove meningioma.
   5.Are there other neurologic signs? Multifocal neurologic signs should suggest multiple sclerosis, and additional neurologic signs such as memory loss should suggest an olfactory groove meningioma or parietal lobe tumor.
   6.Are there signs of a systemic disease? Many systemic diseases may cause anosmia, including hypothyroidism, diabetes, renal failure, hepatic failure, and pernicious anemia
   http://www.wrongdiagnosis.com/a/anosmia/diagnosis.htm