Question Title: olfactory hallucinations/headaches/MS symptoms

Forum: Neurology Forum
Topic: Headache

Posted by CCF Neurology M.D. on February 09, 1998 at 00:58:01:

In Reply to: olfactory hallucinations/headaches/MS symptoms posted by S. Ferguson on February 08, 1998 at 13:05:08:

: About eight months ago I began experiencing olfactory hallucinations -- bad odors, such as burnt wood or dog feces or smoke --
as much as a day before the onset of an extremely intense migraine headache. The headaches occurred about every two weeks for
a couple of months; prior to that I had experienced relatively mild migraines once a month in conjunction with my menses. The
more intense headaches felt like something was burning top and back of my head and caused heart rate and blood pressure to rise
drastically for their duration (maybe 1 day).

As more symptoms developed in the following two months -- dizziness, lightheadedness, loss of balance, weakness in left leg,
pain in left arm and neck, scorching pain in lower back, zinging feeling down spine, sensation of pressure on left side of face
by ear, dishydrosis rash on both palms, heart palpitations, tremors in left hand, general and heat-related fatigue, numbness and
crawlies on face, blurry vision with floaters and "blank spots," urinary frequency, constipation -- I contacted doctor to have general blood
test, hormone test, and glucose tolerance test done. Nothing out of line in results, according to doc. Was referred to neurologist,
who did basic neuro exam and ordered MRI of brain because of bad odor hallucinations. MRI of brain was done without contrast.
Results were normal, although image on-screen had two huge white spots at top of brain stem and in horseshoe-shaped part of brain
(looked like headlights in the center of my brain).

After side of face went numb, MRI of cervical spine was done without contrast. Reports came back normal; image on screen showed
spotty places throughout area to right of vertebrae. Lyme titer test was done. Came back negative.

Symptoms appeared to abate about five-six months after they started, and I thought things were going to be back to relatively "normal" again
(with just occasional crawly feelings on skin, muscle jerks, hyperreflex and pins and needles in left leg, blurry vision, vertigo, fatigue
residuals...) Doc says he doesn't know. Neuro has dropped out of picture.

Three weeks ago, I had to take a TB skin test as part of a job application. Romberg tested positive at that time. TB test left bruises.
Now the olfactory hallucinations and intense headaches are back, more intense than before. Any suggestions as to what type of specialist I might
contact, what type of further testing or evaluation, or what might be going on with brain or body? I'm mid-forties, female, caucasian, mother.
Thank you.

Dear S. Ferguson,

Olfactory hallucinations can be seen with 1. seizures arising a specific part of the brain (temporal lobe) . migraines, although infrequent and 3. several psychiatric disorders. Olfactory symptoms are not seen with MS. You described your olfactory symptoms in a time course that may have some correlation with your migraines. The other symptoms that you described are more extensive, and due to their duration, are more likely related to some other etiology. It was slighly unclear as to whether the OFFICIAL interpretation of your MRI scans was "normal" or showed some "white spots". It is possible that multiple sclerosis may explain SOME of your symptoms with a lesion in the brainstem and cervical spine (weakness, tingling, numbness, loss of balance, dizziness, "zinging" feeling down spine). MS causes symptoms that typically come and go over time which is also similar to what you are describing. I would recommend that you hunt down your neurologist or find another one to discuss your symptoms, review your MRI scans and order additional tests (spinal tap, evoke potentials) that may be helpful to sort through some of your symptoms. If you are interested in being evaluated by one of the neurologist at CCF who specialize in MS (Dr. Rudick, Dr. Cohen), call 1-800-CCF-CARE. Ask for the neurology appointments secretary.

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