Distortion of smells and tastes after coronavirus: the smells in the nose and the taste of food have changed, what to do?

Hallucinations: definition and clinical manifestations

Hallucinations should be distinguished from illusions and fantasies. Such patients see objects and hear sounds that do not really exist, and they look no less vivid and believable than real ones. The difference with illusions is that existing objects appear different to the patient. Thus, at dusk or in the dark, even a healthy person can see illusory objects due to the lack of information received. With hallucinations, attacks are often repeated: the patient hears the same voice for a long time, sees the same objects that are not in reality.

Hallucinations cannot be a variant of the norm, especially if they occur with any frequency. They represent disturbances in the perception of environmental information, and their clinical manifestations depend on the localization of the pathological process. Data enters the brain through analyzer systems: visual, auditory, sensory, olfactory, gustatory, somatosensory. If the signal is disrupted in one or more of them, the following symptoms of hallucinations may occur:

• sensations of touching the skin, movement and changing the location of the insides;
• any sounds that are absent in reality - these can be voices, music, steps, claps and others;
• foreign odors that are not noticeable to others present in the room;
• the appearance of figures, light flashes, various creatures, including non-existent ones.

Negative hallucinations should also be highlighted. In this state, a person, on the contrary, does not notice really existing signals, audio or visual. This pathology is no less dangerous than positive hallucinations, since because of it the patient may not notice objects that threaten his life. The mechanism of its development is also associated with impaired conductivity from the analyzers to the central nervous system.

How to treat olfactory hallucinations?

The ENT doctor will take a thorough history to exclude serious chronic diseases or injuries, prescribe several laboratory tests and conduct a video endoscopic examination to choose treatment tactics. It depends on the root cause - due to what specific lesion the olfactory hallucinations are observed.

Treatment may include medications, physical therapy, and, in rare cases, surgery.

There are no special tactics on how to treat olfactory hallucinations after coronavirus. Damaged nerves in the nasal cavity, affected by infection, return to normal after some time, and phantom odors disappear. Correct sense of smell may partially or completely return without treatment. During recovery from illness, it is recommended to take health-improving physiotherapeutic courses, available at our ENT clinic in Chertanovo.

Physiological characteristics and development mechanism

Normally, information is perceived through five analyzer systems. They function in a complex and allow you to get a complete, three-dimensional picture of what is happening. Visual, auditory, olfactory, tactile and other types of stimuli are captured by different types of receptors and reach the brain in different ways. In the cerebral cortex (central nervous system), they are combined and analyzed, so a single, but complex picture appears in the human mind. Hallucinations are a complex of nervous disorders in which the information generated by the brain differs from reality. This can happen for several reasons:

• violation of signal capture at the level of sensory systems;
• disorders of the central nervous system;
• various poisonings and intoxications that lead to pathological changes in nervous tissue.

The trigger for the development of hallucinations can be various diseases of the sensory organs. Thus, in the absence of information normally received through the eyes (with cataracts, retinal detachment and other pathologies that lead to partial or complete loss of vision), the brain supplements the missing fragments. The mechanism of development of this phenomenon has not yet been fully studied, but there are assumptions about the presence of a kind of blockage in the central nervous system. If normally the brain is able to distinguish real objects from imaginary ones, then with visual impairment this function may disappear. However, hallucinations that develop in the absence of organic damage to sensory organs are more common.

Tactile

Tactile hallucinations in schizophrenia are among the most complex. As a rule, patients claim that insects are crawling on them, or that someone is grabbing their legs. It is very difficult to dissuade the patient from this, since he feels touch on his skin. Even if he does not see insects, he may believe that they are crawling under the skin.

However, such sensations arise not only in schizophrenia. They also occur in healthy people, especially in old age. It’s just that many people are afraid to talk about it, thinking that they will be called crazy.

Possible reasons

Determining the cause of hallucinations is the first and most basic task faced by specialists at the Clinical Brain Institute. The prognosis for the patient and the tactics of his treatment depend on this, as well as the degree of danger of the disease and the possibility of complete rehabilitation. There are several groups of causes that may manifest the same clinical signs, and they can only be distinguished based on the results of more detailed diagnostics.

Psychiatric diseases

One of the main reasons why hallucinations occur, not counting various drug poisonings, is mental disorders. In this case, a violation of the perception of the environment occurs, which is why there is an inadequate assessment of the environment and response disorders. Psychoses of any etiology, schizophrenia and other mental illnesses are often accompanied by hallucinations and delusions. In some patients, these signs appear independently, but in severe forms, a lack of social adaptation, apathy, speech and memory impairment may also be observed. Specialists at the Clinical Brain Institute recommend treatment in a hospital setting using drug therapy and additional methods.

Organic changes in the brain

Hallucinations can also occur as a result of brain diseases. There are no disturbances in peripheral sensory organs (eyes, nose). When certain areas of the cerebral cortex are damaged or irritated, the patient experiences any type of hallucinations. The following pathologies can be the causes of this phenomenon:

• atherosclerosis - cholesterol deposits on the vascular walls, which reduce the diameter of blood vessels, reduce their strength and elasticity, as a result of which the supply of oxygen to the brain decreases;
• short-term increase in blood pressure - also leads to impaired circulation in some parts of the brain;
• stroke is an acute disorder of cerebral circulation, which leads to dangerous consequences;
• Dementia is an acquired, progressive disorder of cognitive function (deterioration of memory, speech), most often manifested in old age.

Hallucinations with organic brain lesions are only one of the symptoms. Depending on the extent and location of the damage, other signs may be observed: impaired motor and cognitive function, delirium, fainting and even paralysis. It is worth understanding that any disorders of the blood supply and brain function can cause dangerous complications, even a regular migraine attack.

Other diseases

Hallucinations can be either one of the main symptoms of some diseases or a nonspecific sign. Their appearance may indicate the development of pathologies of the nervous system, which include:

• delirium - mental disorders that occur with dizziness and other characteristic symptoms;
• migraines - acute attacks of headache associated with impaired cerebral circulation;
• Huntington's disease is a hereditary mental disorder that becomes especially pronounced in middle age;
• schizophrenia is a common mental disorder that can occur with more or less severe symptoms and manifest itself in attacks;
• Parkinson's disease, if it has a long progressive course;
• Alzheimer's disease - severe cases may also be accompanied by impaired brain activity.

Hallucinations can occur with varying degrees of severity. In some patients they appear as flashes of light or tinnitus, while in others they include distinct voices and lifelike figures.

Hallucinations and sleep

Many mental disorders in the initial stages manifest themselves as hallucinations only in a sleepy state. They are especially characteristic of narcolepsy, a disease characterized by various sleep disorders. Such patients periodically experience attacks of uncontrolled drowsiness, which are accompanied by decreased muscle tone and hallucinations while maintaining the ability to adequately respond to external stimuli.

Sleep-related hallucinations can be divided into two categories:

• hypnagogic - appear when trying to fall asleep and represent images of varying degrees of realism;
• hypnopompic - arise at the moment of awakening and can persist for some time, and therefore a person cannot adequately perceive the surrounding reality.

It is worth understanding that periodic occurrences of hallucinations before or after sleep are normal even for a healthy person. During this period, the perception of the environment changes, so the nervous system needs time to adapt. Most often, sleep disorders occur against the background of severe fatigue or stressful situations.

Other reasons

Hallucinations can be caused by any pathology that affects the functioning of the central nervous system. These are congenital or acquired diseases, as well as intoxications of various origins. So, this symptom can be caused by the following factors:

• use of certain types of drugs, large amounts of alcohol;
• increase in body temperature to critical levels;
• poisoning with toxic substances, including some mushrooms;
• pathologies of other organs and systems in which the process of removing toxins is disrupted and they irritate nervous tissue (liver cirrhosis, late-stage renal failure);
• severe dehydration;
• traumatic brain injuries.

Drinking large amounts of caffeine can also cause hallucinations. They will manifest themselves in a mild form (tinnitus, the appearance of spots in the field of vision) and will quickly stop, but they should not be allowed to reappear.

Treatment of pathology

“I constantly smell blood – what should I do?” Still asking yourself this question? But in vain! Because you should immediately go to the clinic to undergo a comprehensive examination. There is a high probability that your body has some undetected pathology. If the terrible diagnosis is confirmed, then treatment options for the disease may be as follows:

• brain tumors – immediate surgical intervention;
• schizophrenia or depression - psychotherapy and a course of antidepressants;
• epilepsy - taking anticonvulsants and other pills;
• circulatory disorders in the brain - metabolic therapy.

Also, as an additional treatment and prevention, a course of taking various vitamins may be prescribed to help normalize the level of microelements in the body. As for hormonal imbalances, special medications are prescribed to normalize metabolism.

Classification of hallucinations

Hallucinations are a complex disorder. Their clinical signs vary from patient to patient, and in some cases remain invisible to others. For their timely detection, as well as for the convenience of diagnosis, classifications have been developed according to various criteria. First of all, true and pseudohallucinations are distinguished. The first of them are realistic and fit harmoniously into the surrounding environment. In the patient’s consciousness they do not differ from real objects. Pseudohallucinations can be distinguished by the following symptoms:

• look foreign, differ from real objects, and a person understands their difference from real sounds, objects, sensations;
• auditory hallucinations are sounds that the patient hears not with his ears, but they appear inside his head or stomach;
• changes in the patient’s behavior - due to the unreality of what is happening to him and the belief that only he can experience such hallucinations, therefore he associates them with fictitious persecutors.

Pseudohallucinations occur during internal disorders and often indicate the development of schizophrenia. Patients understand that the situation that is happening to them is far from normal, and that other people do not experience the changes that are happening to them. However, patients do not call these phenomena hallucinations - more often you can hear about alien persecution and receive other unrealistic explanations.

A separate classification identifies several types of hallucinations according to the methods of their perception:

• auditory - any sounds and voices;
• visual - appear in empty space, and are not a distorted perception of other forms and objects (as with illusions);
• olfactory - the appearance of odors that no one except the patient perceives;
• tactile (more often associated with age-related mental changes or drug use) - itching, tingling of the skin, then visual hallucinations may also appear in the form of insects and other explanations for these sensations;
• gustatory - often a symptom of poisoning delirium, in which the patient is afraid of being poisoned;
• visceral - patients claim that they have a certain object inside them.

Hallucinations can occur separately or in combination. Their diagnosis is difficult, since they largely rely on data from people with mental disorders. According to statistics, visual forms appear more often in acute psychoses, and auditory forms more often in chronic forms of schizophrenia, but in most cases the type of perception of hallucinations does not have any particular diagnostic significance. It is important to distinguish which varieties can harm the patient and others, and which can be considered safe.

1. Imperative hallucinations are imperative in nature. Patients may hear instructions for action in their own heads, but are afraid to admit it. This is the most dangerous variety because it can cause aggression.
2. Associative - complex hallucinations. In such patients, visual images are complemented by auditory accompaniment and vice versa.
3. Reflex - characterized by the presence of a real stimulus that is perceived incorrectly. They should be distinguished from illusions: in this case, the patient can perceive both the stimulus and the hallucination.
4. Extracampal - with such hallucinations, the patient claims that he sees objects that are outside his field of vision (behind or to the side). All varieties, except the first, usually do not pose a danger to the patient and his environment.

Hallucinations can occur in attacks or accompany the patient constantly. In the second case we are talking about hallucinosis syndrome. Voices or images often remain the same: you can hear about a specific voice that sounds in a person's head.

Olfactory hallucinations during Covid

Many patients infected with the SARS-CoV-2 virus, which causes COVID-19, experience some degree of loss of smell and taste. Coronavirus infection is also associated with phantom odors.

For most patients, their sense of smell and taste return to normal after a few weeks at most, as the coronavirus infection passes. Olfactory hallucinations after Covid disappear within the same time frame. But in other cases, the lesions may persist for a longer period of time. Scientists do not yet have clear answers why this happens. If olfactory hallucinations persist after coronavirus for more than a month, it is recommended to consult a doctor.

Diagnostic and treatment methods

Diagnosing hallucinations is a difficult task, so it is important to collect medical history from the patient and those around him. A team of professionals works at the Clinical Brain Institute: doctors will be able to determine the cause of this symptom and prescribe an effective treatment regimen, as well as provide the necessary consultations for the patient’s relatives. Examination methods are selected individually, depending on the data obtained. If the patient has a history of various bruises, open or closed craniocerebral injuries, as well as organic pathologies of the brain, the diagnosis should continue in this direction. In general, the general scheme applies:

• psychiatric examination - consultation includes a conversation with a specialist, as well as samples and tests;
• MRI or CT scan of the brain;
• Polysomnography is a method for diagnosing sleep disorders, also performed at the Clinical Brain Institute.

Treatment is selected individually. If hallucinations are caused by drugs or alcohol, you can get rid of them only after giving up their cause. Inpatient treatment is recommended, and its goal is to cleanse the body of toxins and reduce dependence on drugs and alcohol. In cases where hallucinations occur against the background of severe fatigue, a long rest is indicated, after which they pass. In other cases, drug treatment is necessary:

• neuroleptics are the main method of relieving the manifestations of mental disorders in adults and elderly patients;
• antiparkinsonian drugs, if hallucinations are caused by this particular disease;
• antidepressants - reduce the likelihood of complications;
• means to improve nutrition and blood supply to the brain.

Antipsychotics are a broad group of medications used for various types of mental disorders. Previously, their use was accompanied by a large number of side effects, but new generation drugs are safer for patients. They are mainly prescribed to older people, as well as for Alzheimer's disease. It should be understood that therapy should be carried out under the supervision of a doctor and the patient’s relatives. At the initial stage, improvements often occur, which are accompanied by a feeling of euphoria. This may lead to a desire to cancel any treatment, which is strictly not recommended. With the proper use of medications, significant results can be achieved, some manifestations of schizophrenia and psychosis can be stopped, and the patient’s mental state can be stabilized for a long time. In acute forms and significant impairment of perception, treatment is aimed at eliminating signs of aggression - even if it is impossible to completely restore the functioning of the nervous system, it is important to reduce the risks of unwanted behavior, protecting the patient and others.

The Clinical Brain Institute offers diagnostic and treatment services for patients with hallucinations. There are all conditions for a comprehensive examination, and you can also get advice from a psychiatrist. Depending on the data obtained, treatment can take place at home or in a hospital, and its success depends on many factors: the cause of hallucinations, the age of the patient and his lifestyle, as well as the reversibility of the pathological process.

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Why do people think there is no smell?

Ask yourself the question: “Why do I constantly smell a smell that doesn’t exist?” Then you should go to the clinic for medical help. However, the cause of this symptom can be identified at home. You just need to know the main reasons that contribute to this. For example, the perception of odors may change due to a disruption in the structure of the nasal mucosa. That is, during a cold or sinusitis, a person can perceive familiar odors completely differently than in a healthy state.

However, we should not forget that if a person begins to smell odors that do not actually exist, this may indicate certain pathologies in the body. In this case, you should immediately seek help from a doctor who will not only diagnose the disease, but also prescribe a competent course of treatment. Although in most cases the smells are quite real. It’s just that people around them don’t feel them, since the source is in the patient’s body. This is why it seems that the smell does not really exist.