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Cranial nerve I - the Olfactory nerve

 

Signs and Symptoms of Lesions

Disorders of smell: loss of smell (if bilateral, consider colds, rhinitis, sinusitis etc.; if unilateral, consider possible frontal lobe lesion and/or neoplasm); abnormal keen sense of smell (consider some hysterias or possible cocaine abuse); parosphresia, the perception of smelling nonexistent odors (consider schizophrenia; uncinate gyrus lesions and/or hysteria). 

Smell hallucinations (Cacosmia): consider psychoses; temporal lobe lesions; uncinate seizures.

 

Olfactory Nerve Test

Using nonirritating familiar odors (coffee, therapeutic ointment with a eucalyptus* base, camphor, wintergreen)** with the individualís eyes closed, the practitioner suppresses one nostril (to avoid testing both at same time) and passes the substance under the individualís nose.  The test should be performed bilaterally.  With the individualís eyes remaining closed, ask as to when the odor is introduced, withdrawn, and the type of odor.  Record the findings as it pertains to correctly or incorrectly identifying the odors. (Note which nostril was open.)  Even if the individual is not able to identify the exact odor, but is aware of an odor being introduced, it excludes loss of smell.



Olfactory nerve test

*Note: Check for allergies with eucalyptus.

**Note: Several authors frequently recommend the use of pepper, however, we discourage this. It induces sneezing, which can worsen disc involvement.

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