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Olfactory prodromal symptoms and unilateral olfactory dysfunction are associated in patients with right mesial
J Lehrner1, C Baumgartner, W Serles
1Neurological University Clinic, Vienna, Wien, Austria.
Purpose:
We report a patient with mesial temporal lobe epilepsy (MTLE) with olfactory prodromal symptoms manifested as an unpleasant smell of onions, who was found to have an ipsilateral deficit of olfactory naming (olfactory agnosia).
Methods And Results:
Preoperative olfactory testing revealed a selective right-sided olfactory deficit for naming of odors. Olfactory threshold was within the normal range. The patient has been seizure free after selective amygdalohippocampectomy for 4 months. No olfactory prodromal events have occurred since surgery. Olfactory testing 3 months after resection showed that right-sided odor naming was still impaired.
Conclusions:
We conclude that olfactory prodromal symptoms may be associated with unilateral olfactory dysfunction, and lateralization of seizure origin may be possible by unilateral olfactory testing.
Insights
This study describes a patient with mesial temporal lobe epilepsy (MTLE) experiencing olfactory auras. Unilateral olfactory deficits were identified, suggesting potential for seizure lateralization using olfactory testing.
Area of Science:
- Neurology
- Epileptology
- Olfactory Neuroscience
Background:
- Mesial temporal lobe epilepsy (MTLE) is a common epilepsy syndrome.
- Olfactory symptoms can precede seizures in some epilepsy patients.
- Understanding the link between olfactory auras and brain function is crucial for diagnosis.
Observation:
- A patient with MTLE reported olfactory auras characterized by an unpleasant onion smell.
- Preoperative testing revealed a specific deficit in naming odors on the right side.
- The patient remained seizure-free for 4 months post-surgery, with no recurrence of olfactory auras.
Findings:
- The patient exhibited unilateral olfactory agnosia (impaired odor naming) ipsilateral to the seizure focus.
- Olfactory threshold testing was normal, indicating a selective naming deficit.
- Post-surgical olfactory testing confirmed persistent right-sided odor naming impairment.
Implications:
- Olfactory prodromal symptoms in MTLE may correlate with unilateral olfactory dysfunction.
- Unilateral olfactory testing could be a valuable tool for lateralizing seizure origin in MTLE.
- Further research is warranted to explore the diagnostic utility of olfactory testing in epilepsy.