Burning smell and headache

Burning smell and headache DEFAULT

What’s that smell?

by Deena Kuruvilla, MD

Migraine is associated with a number of disabling aura symptoms such as visual changes, focal numbness, focal weakness and speech changes as well as associated symptoms such as photophobia, phonophobia, nausea and osmophobia. Osmophobia, a sensitivity to smell, is frequently described in 95% of migraine patients and is known to trigger or worsen attacks. Specific odors known to trigger attacks include perfumes, cigarette smoke, motor vehicle exhaust and some cleaning products and foods.

Another way in which smell is involved is through olfactory hallucinations during a migraine attack (OHM). While these cases are much rarer, patients actually smell specific things that are not smelled by the people around them and are associated with their headaches. In this month’s edition of Cephalalgia, Dr. Mainardi and colleagues give us insight into OHM. OHM occur in % of adults and % of children with migraines. OHM has not been as well characterized as osmophobia, so this article describes the specific features of eleven patients with migraine with and without aura, with OHM. The patients were followed for 25 months and asked to keep a detailed headache diary. Over this period, migraine attacks (migraine without aura= , migraine with aura = ) were reported and of these were associated with OHM. The smells would last between three minutes and twenty-four hours on average. In this particular study among patients with OHM, the patients most commonly had migraine without aura and all had less than fifteen headache days monthly. To make sure to rule out other causes for OHM such a temporal lobe epilepsy, the most common cause, the patients had unremarkable physical exams, routine blood tests, brain imaging and electroencephalograms. In most of the patients in the study, OHM occurred during the attacks without aura. Interestingly, photophobia and phonophobia were associated with migraines in all eleven patients but osmophobia was only present in six of eleven cases. Olfactory hallucinations were undesirable in eight patients and they described them as burnt wood, smoke, gas, rotten meat, metallic and sulphur. The smell was pleasant in two patients, who smelled melon, bananas, jasmine and vanilla. While these smells usually occur before or during a migraine attack, they have not been classified as aura. While this study gives us a view into OHM, larger studies are needed to make an accurate description of this feature.

Sours: https://americanheadachesociety.org/news/whats-that-smell/

Is Smelling Burnt Toast a Sign That You're Having a Stroke?

If you're smelling burnt toast, the first thing you should probably do is check your toaster.

Although lots of people think smelling something burning is a sign of a stroke, there's no solid evidence this is true. The idea of smelling phantom burning toast may be kind of amusing — but strokes are serious.

They affect approximately , Americans each year — and around , of those people die as a result. While most people who have strokes are men, most of those who die are women, particularly Black women, who are more likely to die from a stroke than non-Hispanic white women.

We reached out to Dr. Gayatri Devi, a clinical professor of neurology and director of Park Avenue Neurology in New York and member of HealthyWomen's Women's Health Advisory Council, to get more information about symptoms, risk factors and how to decrease your stroke risk.

What is a stroke?

A stroke occurs when the brain's blood supply is reduced or stopped, which causes the brain to be deprived of oxygen and nutrients. This can result in temporary or permanent conditions, including paralysis, memory loss, difficulty swallowing or speaking, pain or tingling and sometimes death.

What are the first signs of a stroke?

The first signs of a stroke include:

  • Sudden numbness or weakness in any part of your body
  • Trouble expressing yourself with language, including the inability to speak or understand what's being said to you
  • Difficulty walking
  • Sudden onset of any kind of confusion
  • A sudden and painful headache

How do the warning signs of a stroke differ from men to women?

While the symptoms for men and women are generally the same, women may also experience fatigue, memory issues, a feeling of general weakness and nausea or vomiting.

How early do the warning signs appear before a stroke happens, and which symptoms of a stroke are more likely to start days in advance?

Sometimes, people will experience slurred or garbled speech, confusion, blindness or double vision and loss, which can last for a few minutes up to an hour. This is known as a transient ischemic attack (TIA) — also known as a mini-stroke — and the symptoms can occur hours or days before a stroke. Around 15% of people who have a stroke have previously had a TIA. People are at higher risk of having a stroke within 90 days after a TIA. People who have a TIA should seek medical help right away.

What are misconceptions people have about strokes?

There is a myth that the smell of burnt toast means you're having a stroke. But the evidence is inconclusive as to whether phantom smells — known as olfactory hallucinations or phantosmia — are associated with having a stroke, and phantosmia seems to be more associated with side effects of certain medications or sinus problems than brain disorders.

There is also a common belief that strokes only affect older adults, but 10%% of strokes occur in people ages 18 to

What other conditions can mimic stroke symptoms?

Conditions and diseases that can resemble symptoms of strokes include:

  • Brain tumors, specifically glioma, meningioma and adenoma/pituitary
  • Migraine
  • Seizures
  • Toxic or metabolic disorders, including hypoglycemia, hypercalcemia and hyponatremia
  • Infectious diseases
  • Psychological disorders

What should people know about “silent strokes”?

A silent stroke — medically known as a silent brain infarction — happens when blood flow is interrupted to a part of the brain that doesn't support any of the body's vital functions, including speech, vision or movement. This means a person does not have any symptoms and the only way they could know if they had a silent stroke is through an MRI or CT scan. Silent strokes can increase the risk of having a stroke attack and dementia.

What are risk factors for a stroke?

Risk factors include:

  • Demographics: Being age 65 and older; having African American, Hispanic American, Native American or Native Alaskan ethnicity; living in the southeastern United States; and being male.
  • Having a family history of strokes.
  • Conditions: Previous stroke or TIA, high blood pressure, high cholesterol, heart disease, diabetes and sickle cell disease.
  • Environmental factors: Smoking, physical inactivity, obesity and drinking too much alcohol.
  • Specific to women: Migraine with aura (while both men and women have migraine headaches, they are more common in women), pregnancy, menopause and using oral contraceptives that are high in estrogen.

When should people seek medical help?

Use the F.A.S.T. method to determine whether to seek medical assistance. If the answer is yes to any of the questions, call immediately:

  • F: Is the person's face drooping?
  • A: Do they have weakness in one of their arms?
  • S: Are they having difficulty with their speech?
  • T: If so, it is time to call emergency care providers.

It's important to get treatment quickly to give the person the best possible outcome.

How can people lower their risk factors for stroke?

To lower their risk of stroke, people can make lifestyle adjustments such as:

  • Increasing physical activity
  • Keeping blood sugar, blood pressure and cholesterol levels in check
  • Quitting smoking
  • Eating healthy
  • Maintaining a healthy weight for their body type
  • Keeping tabs on existing conditions such as heart disease, diabetes, metabolic syndrome, blood clots, lupus and rheumatoid arthritis
Sours: https://www.healthywomen.org/your-health/smelling-burnt-toast-having-stroke
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I have "olfactory hallucinations" in which I smell smoke. What could be causing this?

By Ronald DeVere, MD

These perceived abnormal smells are not actually present in the physical environment. How long they last depends on the olfactory hallucination’s cause.

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Dr. Ronald DeVere responds:

Dr. Ronald DeVereOlfactory hallucinations are perceived abnormal smells—usually unpleasant—that are not actually present in the physical environment. They can come from a number of different areas of the smell system. The length of time these smells last depends on the cause. If the smell of smoke occurs suddenly and continues for less than a few minutes, the site of origin is likely the smell region of the inner temporal lobe of the brain, called the uncus. The source could be an abnormal electrical discharge or "firing" in the brain (a seizure). Potential causes of this abnormality could be a brain tumor, inflammation, stroke, or an injury following head trauma. Confirming the cause requires an imaging study of the brain (MRI) and a brain-wave test (EEG). Usually, results of smell testing will be normal to minimally abnormal in a person who is experiencing this type of seizure. If a seizure disorder is suspected, antiseizure medications may be used to prevent a seizure and thus eliminate the smell.

Olfactory hallucinations lasting more than a few minutes to several hours are usually due to a disturbance of the smell system in the nose (olfactory organ or olfactory nerves) or in the olfactory bulb, which sits just inside the skull above the upper nose level. The term for this type of olfactory hallucination is dysosmia. Common causes of dysosmia are head and nose injury, viral damage to the smell system after a bad cold, chronic recurrent sinus infections and allergy, and nasal polyps and tumors. The brain is usually not the source. In these instances, sense of smell for other odors is often impaired as well, and the results of smell testing typically are abnormal.

Dysosmia usually disappears with time (three months to two years) without treatment. A thorough evaluation for the mentioned causes may include an MRI of the olfactory system and a nasal endoscopy, in which an ear, nose, and throat (ENT) physician looks inside nasal and sinus passages with a magnified scope. Dysosmia can be treated with normal saline nose drops administered with the head lowered (the top of the head should be pointing to the floor). It may also improve with some medications, such as gabapentin—a medication normally used for seizure disorders but that has also been shown to prevent unpleasant odors arising from injured smell receptors or their nerve branches. The use of gabapentin in this instance is considered off label, which means it is not approved by the FDA for this indication. This doesn't mean the medication is not effective and safe, but rather that the drug has not been officially studied and evaluated by the FDA for this condition.

Sours: /articles/i-have-olfactory-hallucinations-in-which-i-smell-smoke-what/
COVID-19 and Loss of Smell Explained

Can Being Sensitive to Smells Impact Migraine?

Most people have probably had a “what’s that smell?” moment. But for some migraine sufferers, odor may play a big role in the quality and occurrence of their head pain.

Osmophobia, or a heightened sensitivity or aversion to smells, is a commonly reported symptom of migraine headaches. Researchers continue to look for answers regarding why intense smells or odors may make migraines worse for some sufferers, why some people report that smells or odors trigger their migraines, and how an odor can even be part of an aura that comes before a migraine. But research remains inconclusive. Let’s take a look.

Understanding Odor Sensitivity and Migraines

A range of smells and odors have been found to be problematic for some migraine sufferers such as:

  • Perfume
  • Cigarette smoke
  • Paint thinner
  • Cleaning products
  • Car exhaust
  • Gasoline

Data varies, but clinical studies report that anywhere between 25 and 50 percent of migraine sufferers experience a heightened sensitivity to odors during their migraine headaches, and up to 50 percent report that strong smells or odors can trigger acute migraine attacks. 1 2 3

Specific odors that may lead to a migraine can vary among individual sufferers, and even from headache to headache for one individual. For example, in a small study of 60 women with migraines, 63 percent (38 people) reported that odors triggered their migraines; however, only about a third of those women had headaches consistently caused by the same odor all the time. 4

Why may odor be such an issue for some? Compared to those without migraines, migraine sufferers can be more sensitive to things in their environment such as light, sound, and odor. With respect to odors, this extra sensitivity is due to increased activation of specific scent and pain receptors in the brain.  Although more studies are needed on the full mechanisms linking odor to migraines, areas within the brain that process odors include regions directly involved in migraine headaches and pain perception. 5

Sours: https://www.excedrin.com/migraines/causes/can-smells-cause-migraines/

Smell headache burning and

Phantom smells may be a sign of trouble

Smelling disorders, including phantom smells and a lack of smell, can be a sign of serious health problems.

In a episode of “Mad Men,” a character with some major health issues — stroke and dementia — mysteriously smelled oranges while eating chocolate ice cream. Shortly after, the man dies while standing in line at the A&P.

Was the phantom orange scent a warning sign of his impending doom?

It’s possible, says Dr. Alan Hirsch of the Smell & Taste Treatment and Research Foundation in Chicago.

“By all means, a phantom smell could mean something serious,” says the psychiatrist and nationally recognized smell and taste expert. “It absolutely needs to be evaluated. It could be a tumor – that’s on the top of your list of things to rule out — but it could also be a cyst or some infectious agent housed in the area of the brain where the smell is processed.”

Brief episodes of phantom smells or phantosmia — smelling something that’s not there — can be triggered by temporal lobe seizures, epilepsy, or head trauma. Phantosmia is also associated with Alzheimer’s and occasionally with the onset of a migraine.

But it’s not typically something sweet that’s conjured up by the brain.

“It’s usually more unpleasant stuff or odors that are hard to describe,” says Hirsch. “People will say it’s chemical-like or talk about a burning smell.”

Common olfactory hallucinations include lots of icky odors. Sufferers report smelling hydrogen sulfide (rotten eggs), bad perfume, garbage, a gas leak, wet dog, pungent body odor or spoiled fish or feces. The brain may trigger such sickening odors instead of agreeable ones because humans learned very early to avoid noxious smells for survival.

“I think a larger area of the brain is represented by bad smells than good smells,” says Hirsch. “And they also may be easier to ‘fire off.’”

Smell disorders aren’t that rare. According to a survey, million Americans have some type of olfactory problem, including anosmia (the inability to smell); hyposmia (a decreased ability to smell); parosmia (a distorted perception, instead of flowers, you smell rotten meat), and phantosmia. Another million people have issues with taste (smell and taste are inextricably linked) including ageusia (the inability to taste); hypogeusia (a decreased ability to taste) and dysgeusia (a distorted ability to taste).

Phantom fragrances can be produced by one or both nostrils and can waft in and out of a person’s life over the course of a few hours or a few days or a few weeks. In some cases, such as that of a year-old New Zealand woman who said her nose caused everything to “smell blimmin’ awful” for 17 years, the condition can come and go for no apparent reason for decades.

In a New York Times story, a woman suffered a succession of unpleasant phantom odors, from dank earth to burnt chili. When antibiotics failed to treat the condition, she simply learned to live with it — and avoid disagreeable odors.

Even if there is no underlying tumor, epilepsy or some other infection, problems with your sense of smell can be very disabling.

“Frequently, [patients will] lose a substantial amount of weight because they can’t stand the way everything tastes,” says Hirsch.

Furthermore, doctors will often treat it like a psychiatric problem, with patients visiting an average of seven physicians before getting help, says Hirsch. The irony is, some people with phantosmia will develop psychiatric disorders, depression or suicidal behavior as a result of their condition.

“Approximately half of my patients who have sought surgery for their distortions have at one time considered suicide because of the hopelessness of living a life where all food smelled like spoiled meat or worse,” Dr. Donald Leopold of the University of Nebraska Medical Center’s otolaryngology department wrote in the edition of Chemical Senses.

Sometimes people think the stink is coming from themselves, which can lead to a condition known as olfactory reference syndrome, says Hirsch.“They’ll wash frequently and won’t go out. It will start with phantosmia, but then they’ll develop secondary paranoia as a result.”


Medical tests such as MRIs, CT scans and EEGs can find common physiological triggers such as tumor, sinus infection and epilepsy, but some patients never understand why they’re suddenly inundated by the smell of garbage or rotting fish or burned coffee or cheese. While pinpointing the cause of phantosmia can sometimes be difficult, treatment is available, including nasal saline drops, anti-depressants, sedatives and anti-epileptic drugs.

Most patients respond to medication, however, a surgical procedure involving the olfactory bulb has also been shown to provide relief. Although normal aging brings a gradual loss of smell, phantosmia sometimes occurs with a reduced ability to smell real scents, another matter that can have serious ramifications, Hirsch says.

“AIDS can initially present with smell loss,” he says. “Or it could be anything from vitamin deficiency to Alzheimer’s to hypothyroidism to head trauma to stroke to diabetes to medication to leprosy.”

One quick way to test whether your sense of smell is diminished is to dish up a bowl of ice cream.

“Take some vanilla ice cream and some chocolate ice cream and see if you can taste the difference,” says Hirsch, who says ninety percent of taste is smell. “If you can’t smell, they both taste the same.”

Sours: https://www.nbcnews.com/health/health-news/phantom-smells-may-be-sign-trouble-n
COVID-19 and Loss of Smell Explained

Imagined smells can precede migraines

By Amy Norton, Reuters Health

4 Min Read

NEW YORK (Reuters Health) - Hallucinated scents can, rarely, be a part of the “aura” that some people perceive before a migraine attack, a new study finds.

About 30 percent of people with recurrent migraines have sensory disturbances shortly before their headache hits.

Those disturbances, known as aura, are usually visual -- such as seeing flashes of light or blind spots. They can also include problems like tingling sensations or numbness, or difficulty speaking or understanding language.

But disturbances in the sense of smell -- so-called olfactory hallucinations -- have not been generally recognized as a part of migraine aura. They are not, for example, listed as an aura symptom in the international criteria doctors use to diagnose migraine.

“I think that’s just because (olfactory hallucinations) have not been commonly reported,” said Dr. Matthew S. Robbins, senior researcher on the new study.

But no one had done a systematic review of the medical literature on the subject until now, he told Reuters Health,

Robbins and his colleagues at the Montefiore Headache Center in New York reviewed 25 reported cases of patients with headaches (migraine in most cases) and olfactory hallucinations.

They also examined records from more than 2, patients seen at their center over 30 months. They found that 14 -- or just under percent -- had described smelling scents in conjunction with their headaches.

“It’s uncommon,” Robbins said, “but it is distinctive.”

Usually, the pre-migraine scents are not sweet. “The most common was of the burning or smoke variety,” Robbins said.

Some headache sufferers described a general burning smell, while others said they smelled cigar smoke, wood smoke or burned popcorn.

After those burning scents, “decomposition” odors -- like garbage or sewage -- were the next most common.

A few people did describe pleasant odors, including the scent of oranges, coffee or, in one case, foie gras.

It’s not clear why the hallucinated odors are most often unpleasant -- or why they are only rarely part of migraine aura.

But Robbins noted that, in general, aura symptoms are thought to involve a phenomenon called “cortical spreading depression” -- where a wave of increased electrical activity in nerve cells of the brain is followed by a wave of depressed activity.

That same phenomenon might underlie olfactory hallucinations, Robbins said. Since the brain’s smell centers occupy much less real estate than its vision centers, that could, in theory, explain why phantom scents are so much less common than visual disturbances.

It’s also possible that some people with migraines and olfactory hallucinations simply don’t recognize the phenomenon, according to Robbins. You know something is wrong when you are seeing zigzag lines, for instance, whereas it’s easy to assume that an odor is actually coming from somewhere.

A number of disorders, including Parkinson’s disease, some epileptic seizures and brain tumors, can cause a person to smell scents that aren’t there.

Knowing that migraines can be preceded by olfactory hallucinations might allow some headache sufferers to forgo “exhaustive medical workups” for other conditions, Robbins noted.

He stressed, however, that when those hallucinations arise without an accompanying headache, they should be thoroughly checked out.

It’s estimated that about 11 percent of the world’s population suffers from migraines. So even though olfactory hallucinations are an uncommon part of aura, there could still be a fairly large number of people who experience them, according to Robbins.

SOURCE: bit.ly/psoVEy Cephalalgia, online September 23,

Sours: https://www.reuters.com/article/us-smells-migraines-idUSTRE79D4L

Now discussing:

Olfactory hallucinations in primary headache disorders: case series and literature review

Background: Olfactory hallucinations (phantosmias) have rarely been reported in migraine patients. Unlike visual, sensory, language, brainstem, and motor symptoms, they are not recognized as a form of aura by the International Classification of Headache Disorders.

Methods: We examined the clinical features of 39 patients (14 new cases and 25 from the literature) with olfactory hallucinations in conjunction with their primary headache disorders.

Results: In a month period, the prevalence of phantosmias among all patients seen at our headache center was %. Phantosmias occurred most commonly in women with migraine, although they were also seen in several patients with other primary headache diagnoses. The typical hallucination lasted minutes, occurred shortly before or simultaneous with the onset of head pain, and was of a highly specific and unpleasant odor, most commonly a burning smell. In the majority of patients, phantosmias diminished or disappeared with initiation of prophylactic therapy for headaches.

Conclusions: We propose that olfactory hallucinations are probably an uncommon but distinctive form of migraine aura, based on their semiology, timing and response to headache prophylaxis.

Sours: https://pubmed.ncbi.nlm.nih.gov//

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