The Neurology of Olfaction (Cambridge Medicine (Paperback))

Testing the sense of smell is often omitted or trivialized during neurological examination. This comprehensive review will address this shortcoming by emphasizing the significance of this important sensory modality. The Neurology of Olfaction describes the anatomy and physiology of human olfaction and how it may be measured. The book covers neurologic disorders in depth and a comprehensive chapter is devoted to neurodegenerative disorders, particularly Alzheimer's disease and Parkinson's disease, where loss of smell is frequent and may be an early preclinical feature that could predict the onset of disease in asymptomatic subjects. Finally, the authors describe methods of treatment for anosmia, evaluate its medicolegal importance, and give guidance for those unfortunate enough to have lost their sense of smell. Written by two experts in the field, this book provides information useful to physicians for assessing and managing chemosensory disorders and summarizes the current scientific knowledge of human olfaction. Cover......Page 1 Half-title......Page 3 Title......Page 5 Copyright......Page 6 Contents......Page 7 Foreword......Page 9 Preface......Page 11 Acknowledgments......Page 13 The nasal cavity......Page 15 The olfactory epithelium......Page 20 The olfactory receptors......Page 25 The olfactory bulb......Page 30 The olfactory cortex......Page 35 Piriform cortex......Page 37 Amygdala......Page 38 Orbitofrontal cortex......Page 41 Odor processing and CNS coding mechanisms......Page 43 Odor adaptation......Page 46 Odor memory......Page 47 Human pheromones......Page 48 Specific anosmia......Page 51 Blind smell......Page 52 Age......Page 53 Hormonal factors......Page 55 Cigarette smoking......Page 58 Pollution......Page 59 Demography......Page 60 REFERENCES......Page 61 Medical history and examination......Page 73 Olfactory testing......Page 76 Odorant presentation procedures......Page 78 Psychophysical tests......Page 80 Odor identification tests......Page 81 Odor threshold tests......Page 86 Odor memory tests......Page 90 Odor rating and magnitude estimation tests......Page 92 The electro-olfactogram......Page 96 Olfactory event-related and evoked potentials......Page 105 Acoustic rhinometry......Page 109 Rhinomanometry......Page 110 Computerized axial tomography......Page 112 Magnetic resonance imaging......Page 113 Positron emission tomography......Page 115 Functional magnetic resonance imaging......Page 117 Ciliary motility tests......Page 120 Body odor in medical diagnosis and development of the electronic nose......Page 121 REFERENCES......Page 124 Types of olfactory disturbance......Page 133 Agnosia......Page 135 Hyperosmia......Page 136 Hallucinations, dysosmias, and phantosmias......Page 137 Disorders affecting olfaction......Page 138 Local nasal disease......Page 139 Viral infections......Page 141 Bacterial infections......Page 143 Head trauma......Page 146 Medication......Page 151 Airborne toxins......Page 152 Tumors......Page 154 Migraine......Page 157 Epilepsy......Page 158 Multiple sclerosis......Page 161 Korsakoff psychosis......Page 162 Miscellaneous causes of anosmia......Page 163 Rare genetically determined disorders......Page 164 REFERENCES......Page 165 4 Neurodegenerative diseases that affect olfaction......Page 175 Pathological studies of the olfactory system......Page 176 Clinical evidence for olfactory dysfunction in Alzheimer's disease......Page 178 Down syndrome......Page 182 Olfactory epithelium......Page 183 Olfactory bulbs......Page 184 Central olfactory changes......Page 185 Clinical evidence for olfactory dysfunction in Parkinson's disease......Page 187 Selective anosmia in sporadic Parkinson's disease?......Page 190 Familial and presymptomatic Parkinson's disease......Page 191 Parkinsonism......Page 197 Lewy body disease......Page 198 Multiple system atrophy......Page 199 Corticobasal degeneration......Page 200 Progressive supranuclear palsy......Page 202 Vascular parkinsonism......Page 203 Drug-induced Parkinson's disease......Page 204 Guam Parkinson's disease-dementia complex......Page 205 Essential tremor......Page 206 Cerebellar ataxia......Page 208 Motor neuron disease (amyotrophic lateral sclerosis)......Page 209 Huntington's disease (Huntington's chorea)......Page 210 Diagnostic implications for neurodegenerative disorders......Page 211 The olfactory vector hypothesis......Page 212 Environmental versus genetic determinants......Page 214 Environmental agents known to be transported into the brain through the nose......Page 217 Primacy of olfactory involvement......Page 218 Nasal metabolism of xenobiotics......Page 219 Summary......Page 221 REFERENCES......Page 222 Investigation of smell loss......Page 237 Treatment......Page 238 Hyperosmia......Page 240 Medicolegal aspects......Page 241 Detection of malingering and patients with nonorganic psychiatric disorders......Page 244 General advice and vocational issues......Page 249 Summary......Page 251 REFERENCES......Page 252 Index......Page 255 Cover 1 Half-title 3 Title 5 Copyright 6 Contents 7 Foreword 9 Preface 11 Acknowledgments 13 1 Anatomy and physiology 15 The nasal cavity 15 The olfactory epithelium 20 The olfactory receptors 25 The vomeronasal organ 30 The olfactory bulb 30 The olfactory cortex 35 Piriform cortex 37 Amygdala 38 Orbitofrontal cortex 41 Cerebellum 43 Odor processing and CNS coding mechanisms 43 Perception of odor hedonics 46 Odor adaptation 46 Odor memory 47 Human pheromones 48 Factors that influence normal function 51 Specific anosmia 51 Blind smell 52 Age 53 Hormonal factors 55 Cigarette smoking 58 Pollution 59 Demography 60 Summary 61 REFERENCES 61 2 Clinical evaluation 73 Introduction 73 Medical history and examination 73 Olfactory testing 76 Odorant presentation procedures 78 Psychophysical tests 80 Odor identification tests 81 Odor threshold tests 86 Signal detection tests 90 Odor memory tests 90 Odor rating and magnitude estimation tests 92 Electrophysiological tests 96 The electro-olfactogram 96 Olfactory event-related and evoked potentials 105 Nasal airway patency and airflow measurement 109 Acoustic rhinometry 109 Rhinomanometry 110 Structural imaging 112 Computerized axial tomography 112 Magnetic resonance imaging 113 Functional imaging 115 Positron emission tomography 115 Functional magnetic resonance imaging 117 Other 120 Ciliary motility tests 120 Body odor in medical diagnosis and development of the electronic nose 121 Summary 124 REFERENCES 124 3 General disorders of olfaction 133 Types of olfactory disturbance 133 Specific anosmia 135 Agnosia 135 Hyperosmia 136 Hallucinations, dysosmias, and phantosmias 137 Localization of olfactory disorder 138 Disorders affecting olfaction 138 Local nasal disease 139 Viral infections 141 Bacterial infections 143 Head trauma 146 Exposure to medication or airborne toxins 151 Medication 151 Airborne toxins 152 Tumors 154 Endocrine disease 157 Migraine 157 Epilepsy 158 Olfactory reflex epilepsy 161 Multiple sclerosis 161 Miscellaneous disorders of olfaction 162 Korsakoff psychosis 162 Schizophrenia 163 Miscellaneous causes of anosmia 163 Rare genetically determined disorders 164 Summary 165 REFERENCES 165 4 Neurodegenerative diseases that affect olfaction 175 Alzheimer's disease 176 Pathological studies of the olfactory system 176 Clinical evidence for olfactory dysfunction in Alzheimer's disease 178 Down syndrome 182 Parkinson's disease 183 Pathological studies of the olfactory system 183 Olfactory epithelium 183 Olfactory bulbs 184 Central olfactory changes 185 Clinical evidence for olfactory dysfunction in Parkinson's disease 187 Selective anosmia in sporadic Parkinson's disease? 190 Familial and presymptomatic Parkinson's disease 191 Parkinsonism 197 Lewy body disease 198 Multiple system atrophy 199 Corticobasal degeneration 200 Progressive supranuclear palsy 202 Vascular parkinsonism 203 Drug-induced Parkinson's disease 204 Guam Parkinson's disease-dementia complex 205 X-linked recessive dystonia-parkinsonism ("Lubag") 206 Essential tremor 206 Cerebellar ataxia 208 Motor neuron disease (amyotrophic lateral sclerosis) 209 Huntington's disease (Huntington's chorea) 210 Diagnostic implications for neurodegenerative disorders 211 The olfactory vector hypothesis 212 Environmental versus genetic determinants 214 Environmental agents known to be transported into the brain through the nose 217 Primacy of olfactory involvement 218 Nasal metabolism of xenobiotics 219 Summary 221 REFERENCES 222 5 Investigation, treatment, and general management of olfactory disease 237 Investigation of smell loss 237 Treatment 238 Hyperosmia 240 Medicolegal aspects 241 Detection of malingering and patients with nonorganic psychiatric disorders 244 General advice and vocational issues 249 Summary 251 REFERENCES 252 Index 255

provides Information Useful To Physicians For Assessing And Managing Chemosensory Disorders And Summarizes The Current Scientific Knowledge Of Human Olfaction.

doody Review Services

reviewer:joseph I. Sirven, Md(mayo Clinic Hospital)
description:this Survey Of The Anatomy, Physiology, And Pathology Of The Olfactory Pathway Also Covers How Various Neurological Disorders Impact Olfaction.
purpose:olfaction And The Disorders That Affect It Are The Least Appreciated Disorders Of The Major Senses. Olfactory Testing And Clinical Examination Of Smell Are Often Overlooked And Not Factored Into Medical Diagnostics. The Book Strives To Fill The Niche, Setting Out What Is Known.
audience:the Book Is Written For General Clinical Neurologists. Each Chapter Is Well Detailed With Useful Clinical Pearls And A Synopsis Of What Is Known In The Area. The Authors Are Established Experts In The Field.
features:the Five Broad Chapters Discuss Anatomy, Physiology, Clinical Evaluation, General Disorders Of Olfaction, Neurodegenerative Diseases Impacting Olfaction, And Therapeutics. The Useful Figures, Tables, Images, And Plates In The Center Are The Best Features Of The Book.
assessment:this Book On Olfaction Fills A Definite Void In The Literature. The Authors Are Correct In Noting That Olfaction Is Overlooked In Diagnosis And Therapy. Their Book Will Help Readers Refocus On The Importance Of Testing For Disorders Of Olfaction. I Can Easily See Any Clinical Neurologist, Neurology Resident, Fellow, Or Medical Student Using This Book To Gain A Better Understanding Of This Sense.

"Testing the sense of smell is often omitted or trivialized during neurological examinations. This comprehensive review addresses this shortcoming by emphasizing the significance of this important sensory modality. The Neurology of Olfaction describes the anatomy and physiology of human olfaction and how it may be measured. The book covers neurological disorders in depth, and a comprehensive chapter is devoted to neurodegenerative disorders, particularly Alzheimer's disease and Parkinson's disease, where loss of smell is frequent and maybe an early preclinical feature that could predict the onset of disease in asymptomatic subjects. The olfactory vector hypothesis, which proposes that a toxin may gain access to the brain via the nose, is appraised fully. Finally, the authors describe methods of treatment for anosmia, evaluate its medicolegal importance, and give guidance for those unfortunate enough to have lost their sense of smell." "Written by two experts in the field, this book provides information useful to physicians for assessing and managing chemosensory disorders - with appropriate case-histories - and summarizes the current scientific knowledge of human olfaction. It will be of particular interest to neurologists, otolaryngologists, psychologists, psychiatrists, and neuroscientists."--BOOK JACKET