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Olfactory reference syndrome in a patient with partial epilepsy
1Department of Neurology, New York University School of Medicine, New York, USA.
Abstract:
A 49-year-old man with right temporal lobe epilepsy developed the chronic delusion that his body emitted a foul odor (olfactory reference syndrome). Before the delusional symptoms, he had partial seizures with unpleasant olfactory hallucinations. Subsequently ictal olfactory symptoms abated but a disabling delusional syndrome developed. The only prior case of the olfactory reference syndrome in a patient with epilepsy had a right frontal lesion. The case further supports the association of right hemisphere lesions and delusional disorders.
Insights
Epilepsy may lead to delusional disorders. A patient with temporal lobe epilepsy developed olfactory reference syndrome, a delusion of foul body odor, suggesting a link between right hemisphere brain lesions and delusions.
Area of Science:
- Neurology
- Psychiatry
- Neuroscience
Background:
- Epilepsy is a neurological disorder characterized by recurrent seizures.
- Olfactory hallucinations can precede or accompany seizures.
- Delusional disorders are psychiatric conditions involving persistent false beliefs.
Observation:
- A 49-year-old man with right temporal lobe epilepsy experienced olfactory hallucinations before developing a chronic delusion of emitting a foul odor (olfactory reference syndrome).
- The patient's ictal olfactory symptoms ceased as the delusional syndrome emerged.
- A previously reported case of olfactory reference syndrome in epilepsy involved a right frontal lesion.
Findings:
- This case highlights a potential association between right temporal lobe epilepsy and the development of delusional disorders.
- The progression from olfactory hallucinations to a fixed delusion suggests a possible evolution of neurological dysfunction.
- The findings support the hypothesis linking right hemisphere lesions to delusional syndromes.
Implications:
- This case contributes to understanding the complex relationship between epilepsy, specifically right-sided temporal lobe involvement, and psychiatric comorbidities.
- It suggests that lesions in the right hemisphere may predispose individuals to developing delusional disorders.
- Further research is warranted to explore the neurobiological mechanisms underlying this association and its clinical implications for epilepsy management.