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Smell and taste in clinical neurology

physician-Maushmi
Medically reviewed by Maushmi Sheth
physician-Maushmi
Medically reviewed by Maushmi Sheth

Loss of smell can be an independent disease or a symptom of any other pathology. Therefore, doctors argue that the causes and treatment of anosmia as the problem in question is classified in medicine should go side by side. The choice of the therapeutic regimen will depend on what triggered the loss of smell.

Doctors use smell testing to measure the loss of smell. As everyone already knows, SARS-CoV-2 is a type of coronavirus that infects humans and causes COVID-19. This disease is characterized by respiratory complications, usually with mild symptoms (80% of cases). In some cases, these respiratory symptoms are accompanied by other manifestations. In particular, according to the latest research, up to 88% of COVID-19 patients lose their sense of smell and taste. In most of these patients (80%), their sense of smell and taste recover on their own over time. For those whose sense of smell is not recovering or is recovering incompletely, at the moment, there is only one treatment option- training the sense of smell. 

Moreover, one of the characteristic symptoms of coronavirus infection is loss of smell. Olfactory dysfunction, considered the earliest and most important predictor of disease, differs significantly from anosmia caused by other infectious agents. For a certain proportion of patients, it can have severe psychological consequences. Therefore, recovery of the sense of smell after coronavirus is becoming the cornerstone of clinical neurology.

Causes of loss of smell in clinical neurology

Loss of smell and taste can be triggered by:

  • The malformation of the nose and sinuses. Either congenital or acquired. In the first case, we say that a person is already born with a similar problem and, from birth, does not distinguish between aromas. On the other hand, acquired disorders of the nose structure are the consequences of trauma, and in this case, the sense of smell is lost immediately after the onset of the pathology.
  • Diseases of the nasal cavity are chronic and acute. In this case, they talk about a temporary problem; for example, loss of smell with a cold does not require any specific treatment, and everything is restored on its own.
  • Head trauma. If there was a severe traumatic brain injury, then the nerve fibers are damaged by the bones of the skull (their fragments). Most often, the problem occurs when the occipital, temporal, and ethmoid bones are damaged.
  • Tumors of the brain, nose, and sinuses are benign or malignant. A distinctive feature of such anosmia is its slow development; the patient may not pay attention to an already progressing problem for a long time.
  • Smoking. Tobacco smoke and toxins in it and tar act on the nasal mucosa and sinuses irritatingly. With prolonged smoking, combined anosmia may develop, loss of taste and smell at the same time.

Intoxication can also affect the intensity level of smell. If the body is constantly influenced by benzene, cadmium, then over time, the development of anosmia is inevitable; this can happen against the background of specific working conditions.

In addition, post-viral anosmia occurs in 66-70% of cases of COVID-19 infection. It appears earlier than other symptoms and is often accompanied by taste disorders. Unfortunately, to date, a complete understanding of the reason for this deviation remains unclear. 4 etiological factors underlying olfactory dysfunction in clinical neurology are considered:

  • obstruction of the nasal passages due to acute inflammation and congestion in the mucous membrane
  • penetration of the pathogen through the ethmoid bone directly into the area of ​​the cerebral cortex that recognizes odors (in many patients, anosmia is not accompanied by a runny nose and nasal congestion)
  • infection of peripheral neurons, destruction of the neuroepithelium, which performs a receptor function, and disruption of central communication with the olfactory nerve
  • combined disorder.

In other words, the loss of the ability to sense odors can be caused both by a violation of the structure of the nasal mucosa and by damage to the sensory olfactory system itself.

Anosmia treatment

Anosmia treatment

In clinical neurology, treatment for loss of smell should begin with an examination by a physician. First, it is necessary to find out the cause of this condition, carry out smell testing and choose a treatment method:

  • Surgical intervention for the abnormal structure of the nose and sinuses. The problem lies in the fact that the operation must be done in early childhood (maximum four years), and doctors are categorically against interventions in the structure of the face until the growth of a person stops. Even if the work has been done, full recovery cannot be achieved.
  • Restoration and treatment of the main pathology with injuries of the nose, face, and head. If the nerve fibers have not been damaged, then the sense of smell returns after the end of the main therapy. This recovery happens gradually; full rehabilitation ends no earlier than three months later.
  • Colds, chronic sinusitis, sinusitis, and rhinitis are factors that provoke a temporary loss of smell. How to cure anosmia in this case, the attending physician will explain, and most likely, these will be recommendations for the use of anti-inflammatory nasal drops.
  • The degree of recovery of the sense of smell directly depends on which centers are affected. If the peripheral variant (nerve fibers are not damaged), the chances of regaining the lost ability to perceive and distinguish odors are very high.

How to speed up the recovery of your sense of smell after coronavirus? Symptomatic therapy is recommended, aimed at stopping inflammation in the nasal cavity to alleviate the condition. To do this, rinse the nose with saline and use vasoconstrictor, anti-inflammatory, or hormonal intranasal sprays. Of course, before using these drugs, it is necessary to consult a doctor, as they can lead to harmful side reactions.

Experts advise adding natural enhancers of taste and smell to food to train the gustatory and olfactory function. With a disorder associated with damage to the sensory system of smell, neurologists recommend correcting through internal listening and remembering tastes and scents. This procedure, called olfactory training, is used to reconstruct neural connections and activate olfactory receptors. You must choose at least five powerful aromas (coffee, garlic, mint, aromatic oils, vanilla, citrus, etc.) and sniff each ingredient for 10-20 seconds, at least two times a day. And the most important thing is not to panic and remember the success of restoring the work of taste and olfactory receptors after coronavirus largely depends on the quality of auxiliary therapy.

The return of the ability to distinguish between odors is a favorable sign of recovery in clinical neurology. Recovery of the sense of smell after coronavirus can vary from 8-14 days to 1-3 months after the resolution of the disease. Unfortunately, in rare cases, irreversible damage is possible. A similar situation is associated with a history of chronic pathologies of the paranasal sinuses, neurological diseases, trauma, or surgical interventions on the brain.

Recovery of taste after coronavirus most often coincides with the return of the sense of smell or is shifted by another 1-2 weeks from the onset of the regression of symptoms. However, in severe cases, the taste can return within six months, and sometimes not completely.

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Lone Star Neurology
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Edward Medina
Edward Medina
15:34 30 Jun 22
Just such an amazing staff that makes you feel like part of their family. I’ve been going there for over 5 years now... and each visit I get the very best care and treatments that I have ever received in the 20+ years that I’ve been dealing with severe debilitating migraines. Since i started seeing them the number of my migraines has dropped from 15-20 a month to 2-3 every 3 month. I highly recommend them …they will change your life!read more
Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been prepared.read more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well together.read more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your business.read more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any cookies.read more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going there.read more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my treatment.read more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to finish.read more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 stars.read more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his staff.read more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best treatment.read more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my doctor.read more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding solutions.read more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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  1. January 7, 2024

    Thank you for the valuable information. I lost my sence of smell and taste in July 2021 due to corona and it has not returned yet.

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