OBSERVATION Basile N. Landis, MD; Pierre R. Burkhard, MD Background: Impaired olfaction is a common, nonmo- Main Outcome Measures: Iodine I 123–labeled iof- lupane single-photon emission computed tomography and tor manifestation of Parkinson disease (PD). However, olfactometric testing results. to our knowledge, qualitative olfactory disturbances, such as odor distortions, have not been extensively reported Results: The I-labeled ioflupane single-photon emis- in this condition. sion computed tomography showed reduced radio- tracer uptake in both striatum more marked in the pu- Objective: To describe 2 patients who reported posi- tamen and on the left side in patient 1 and reduced tive olfactory symptoms preceding typical PD, which were radiotracer uptake in both putamen more marked on the consistent with olfactory hallucinations (phantosmias) right side in patient 2. Olfactometric testing showed mild in the absence of major smell deficit. hyposmia in patient 1 and normal function in patient 2. The disappearance of the phantosmias in both patients coincided with the development of typical PD. Design: Case series. Conclusion: We propose phantosmia as a new premo- tor manifestation of PD and suggest that qualitative ab- Setting: University hospital. normalities of olfaction, rather than the typical smell loss demonstrated in this condition, should be
JAMA Neurology – American Medical Association
Published: Sep 1, 2008
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