The Smell Of A Stroke: A Warning Sign

It is a common misconception that smelling burning toast is a sign of a stroke. However, there is no solid evidence to support this claim. While phantom smells can be a result of a stroke, they are not a primary indicator of one occurring. If you are experiencing persistent phantom smells, it is best to consult a doctor, as it may be indicative of an underlying medical condition.

Smelling burnt toast is a common misconception

That being said, changes in smell may occur after a stroke. A stroke occurs when the blood supply to the brain is cut off, killing brain cells. If a stroke damages the parts of the brain that interpret information about smell from the nose, it can cause changes in the sense of smell. A study in BMC Neurology found that nearly a third of participants who had strokes experienced a reduced ability to smell, and 15% lost their sense of smell altogether in the year following their strokes.

It is important to note that changes in smell are not primary red flags for stroke, but they can be one of the effects. Other common effects of stroke include changes in taste, balance, vision, facial nerves, and speech. If you are experiencing any of these symptoms, it is important to seek immediate medical attention as timely treatment can lead to more effective recovery.

In summary, while smelling burnt toast is not a typical sign of a stroke, changes in smell can occur after a stroke due to damage to the parts of the brain that interpret smells. However, this is not a classic sign of stroke, and there are other more common symptoms to look out for, such as those summarized by the acronym BEFAST or FAST.

Olfactory hallucinations are called phantosmia

Phantosmia can be caused by various medical and neurological conditions, such as nasal infections, nasal polyps, dental problems, migraines, head injuries, strokes, Parkinson's disease, seizures, or brain tumours. It can also be a symptom of certain mental disorders, including depression, bipolar disorder, intoxication, withdrawal from drugs and alcohol, or psychotic disorders. Environmental factors like smoking, exposure to certain chemicals, or radiation treatment for head or neck cancer can also trigger phantosmia.

Olfactory hallucinations can be distinguished from parosmia, which is a distorted sense of smell. With phantosmia, an individual smells something that is not present, while with parosmia, the brain changes how something smells. For instance, with parosmia, freshly brewed coffee might be perceived as burnt toast.

If phantom smells persist or cause significant discomfort, medical treatments such as nasal saline drops, antidepressants, anticonvulsant medications, or anaesthesia to parts of the nose may be recommended. In rare cases, surgical procedures to remove the olfactory nerves or bulbs may be considered.

A stroke can affect your sense of smell

It is a common misconception that smelling burning toast is a sign of a stroke. However, while this is not a typical indicator, a stroke can still affect your sense of smell.

A stroke occurs when the blood supply to the brain is cut off, killing brain cells. If a stroke impacts the parts of the brain that interpret information about smell from the nose, it can cause changes to your sense of smell. This can manifest as a reduced ability to smell (hyposmia), a distorted sense of smell (dysosmia), or a complete loss of smell (anosmia).

According to a study in BMC Neurology, which looked at 78 participants who had strokes, almost a third of them experienced a reduced ability to smell, and 15% lost their sense of smell altogether within a year of their strokes. Older individuals tended to have higher levels of impairment, which may be related to age-related changes in smell, even without a stroke.

Changes to one's sense of smell can have a significant impact on their quality of life. It can affect their emotional and physical well-being, as certain smells can trigger powerful emotions and memories. Additionally, it can make eating a healthy diet more challenging, as the loss of smell can reduce one's appetite and lead to weight loss or malnutrition. It can also increase the risk of another stroke, as it may lead to an unhealthy diet and weight gain.

If you experience changes in your sense of smell after a stroke, it is important to seek help from a healthcare professional, such as your GP or a stroke nurse. They can provide advice, treatment, and referrals to specialists, such as an ear, nose, and throat specialist (ENT) or a dietitian. Additionally, maintaining good oral hygiene and practising smell training can also help with recovery.

A stroke occurs when the brain's blood supply is cut off

A stroke is a life-threatening medical emergency that occurs when the brain's blood supply is cut off, starving brain cells of oxygen and causing them to die. This interruption to the blood flow can be caused by blocked blood vessels or bleeding in the brain. As a result, the affected area of the brain is unable to function properly, leading to various physical and cognitive impairments.

The effects of a stroke depend on the location and extent of the brain damage. Strokes can affect either side of the brain, resulting in paralysis, sensory changes, and behavioural differences on the opposite side of the body. For instance, a stroke in the left side of the brain typically impacts the right side of the body, causing paralysis, sensory changes, and speech or language difficulties. On the other hand, a stroke in the right side of the brain usually affects the left side of the body, leading to paralysis, sensory changes, and spatial thinking or imagery issues.

Strokes can also occur in the brain stem, which is the most severe form as it can result in a 'locked-in' state, where the patient is conscious but unable to move or speak, except for vertical eye movements and blinking.

While changes in smell may not be a primary indicator of a stroke, it can be a possible symptom. A stroke can affect an individual's olfactory function, leading to a reduced or complete loss of smell. This can have a significant impact on a person's quality of life, emotional well-being, and nutritional intake. However, it is important to note that phantom smells, such as perceiving the scent of burning when there is none, are not typically associated with a stroke but can be caused by other conditions or medications.

It is crucial to recognise the signs of a stroke, as immediate medical attention is critical to prevent permanent damage or death. The BEFAST acronym is a helpful tool to identify the warning signs:

• Balance: Look for sudden loss of balance, dizziness, or muscle weakness, especially on one side of the body.
• Eyes: Watch for sudden loss of vision or double vision in one or both eyes.
• Face: Ask the person to smile and observe for drooping on one or both sides of the face, indicating muscle weakness.
• Arms: Check for one-sided weakness by asking the person to raise both arms; one arm may sag or drop.
• Speech: Listen for slurred speech or difficulty speaking or understanding speech.
• Time: Act quickly and call emergency services, as time is critical in treating a stroke effectively.

Seek medical help if you experience persistent phantom smells

Phantom smells, or olfactory hallucinations, are a recognised phenomenon in medicine, known as phantosmia. If you experience persistent phantom smells, it is important to seek medical advice to determine the underlying cause. While phantosmia is not typically associated with heart attacks, it has been linked to several medical conditions, including:

• Traumatic head injuries
• Upper respiratory infections
• Parkinson's disease
• Allergies
• Sinus problems
• Brain tumours
• Neurological conditions
• Schizophrenia

In addition, certain medications and aging can also contribute to experiencing phantom smells.

To diagnose phantosmia, a doctor will typically take a detailed medical history, perform a physical examination, and may request specific tests or imaging scans to rule out possible causes. Treatment options depend on the underlying cause and range from medication to, in severe cases, surgery.

It is important to note that while phantom smells may not always indicate a serious condition, they can significantly impact your quality of life and should not be ignored. If you are experiencing persistent or recurrent phantom smells, consult your healthcare provider for evaluation and appropriate treatment.

Furthermore, while smelling burnt toast or other phantom odours may not be a typical indicator of a stroke, it is crucial to recognise the warning signs of a stroke and act promptly. Use the acronym BEFAST or FAST to help identify a stroke:

• Balance: Dizziness, disorientation, and muscle weakness, especially on one side of the body, can affect balance.
• Eyes: Vision changes, such as blurry vision or loss of vision in one or both eyes, may occur.
• Face drooping: Strokes can cause facial nerve weakness, resulting in a drooping appearance.
• Arm weakness: Weakness or paralysis on one side of the body, including the inability to raise the arm.
• Speech: Slurred speech or difficulty speaking or understanding speech.
• Time: Call for emergency assistance immediately if you observe any of the above symptoms.

Remember, time is critical when it comes to stroke treatment, so don't delay in seeking help.

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