Phantosmia: When Your Nose Hallucinates
Smelling smoke, chemicals, or rot when nothing is there? Your olfactory system is misfiring—this is treatable and you are not imagining it.
Phantosmia (smelling things not present) has neurological causes that can be identified and treated.
What is Chronic Sneezing?
Phantosmia is the perception of smells that don't exist—olfactory hallucinations where odor is detected without any physical source. Unlike parosmia (distorted real smells), phantosmia involves smelling things completely absent from the environment. Common phantom odors include smoke, chemicals, rotting food, metallic smells, or burning. The causes range from benign (sinus inflammation causing spontaneous nerve firing) to serious (temporal lobe epilepsy, brain tumors). Evaluation is essential to rule out neurological causes and treat the underlying condition.
Common Misconception
“Phantosmia means you're crazy or imagining things.”
Biological Reality
Phantosmia occurs when olfactory neurons or brain centers generate signals without odor molecule input. Causes include: sinus inflammation causing spontaneous nerve firing, damage causing hyperresponsive neurons sending false signals, temporal lobe epilepsy (olfactory seizures), brain tumors affecting olfactory cortex, or neurodegenerative diseases. The smell is real to your brain—it's miscommunication, not imagination.
Persistent phantom smells require evaluation to rule out serious causes.
Symptoms That Often Occur Together
Phantom smells require evaluation. Book assessment now.
Get EvaluatedWhy Does Sneezing Happen?
Phantosmia requires investigation for these common underlying causes.
How It Works
Phantosmia develops through several mechanisms: (1) Peripheral origin—damaged olfactory neurons become hyperresponsive, firing spontaneously without odor stimulus; (2) Central origin—brain's olfactory cortex generates perceptions without peripheral input (like visual hallucinations); (3) Sinus origin—inflamed sinuses cause abnormal pressure or stimulation on olfactory neurons; (4) Epileptic origin—temporal lobe seizures can present as brief olfactory hallucinations (uncinate fits); (5) Tumor-related—brain tumors in the olfactory cortex or temporal lobe cause phantom perceptions; (6) Neurodegenerative—Parkinson's and Alzheimer's can cause phantosmia as part of olfactory dysfunction.
Common Underlying Causes
Post-Viral Phantosmia
35%Damaged neurons fire spontaneously after viral damage
Sinus Inflammation
25%Inflamed sinuses stimulate olfactory neurons abnormally
Temporal Lobe Epilepsy
5%Seizures originate in olfactory cortex causing brief hallucinations
Head Trauma
15%Damage to olfactory pathway causing misfiring
Neurodegenerative
10%Early Parkinson's or Alzheimer's causes olfactory dysfunction
Common Triggers
Neurological
Nasal
How We Identify the Cause
Phantosmia requires ruling out serious neurological causes.
Our Diagnostic Philosophy
Standard ENT evaluation often finds nothing wrong and dismisses phantosmia as imaginary. At Healers Clinic, we recognize phantosmia has real causes—we investigate both peripheral (nose/sinuses) and central (brain) origins. We rule out serious causes (tumors, epilepsy) then treat what we find: sinus disease, post-viral dysfunction, or neurological conditions. Treatment depends on cause—there's no single solution but many addressable underlying conditions.
Olfactory Testing
Assess olfactory function and patterns
Function levels, associated smell loss
Sinus CT Scan
Assess sinus contribution
Sinus inflammation, polyps, structural issues
MRI Brain
Rule out brain tumors and epilepsy
Tumors, lesions, temporal lobe abnormalities
EEG
Rule out temporal lobe epilepsy
Seizure activity patterns
Pathways to Relief
Sinus Treatment
Treat sinus inflammation causing peripheral phantosmia
- Reduces inflammation
- Addresses peripheral cause
- Often effective
Smell Training
Help recalibrate damaged olfactory neurons
- Evidence-based therapy
- May reduce phantom smells
- Safe and non-invasive
Neurological Treatment
Address central causes (epilepsy, tumors)
- Antiepileptic drugs if needed
- Surgical removal if tumor
- Specialist referral
Our Approach vs. Conventional Care
Conventional Approach
- Often finds nothing and dismisses as imaginary
- Doesn't rule out serious causes
- No treatment offered
Our Integrative Approach
- Thoroughly investigates both peripheral and central causes
- Rules out tumors and epilepsy
- Offers targeted treatment
Expected Healing Timeline
Phase 1: Investigation
Week 1MRI, EEG if indicated, sinus CT, and rule out serious causes to determine peripheral vs. central cause
Phase 2: Treatment
Weeks 2-8Treat identified cause and symptom management for reduction or elimination of phantom smells
Phase 3: Monitoring
Months 2-6Track improvement, adjust treatment, and neurological follow-up if needed for resolution or management
At-Home Management Tips
Daily nasal sinus irrigation to reduce sinus inflammation contributing to phantosmia
Avoid known triggers (often perfumes, chemicals) to reduce episodes
Sniff 4 pure odors twice daily for smell training to help recalibrate neurons
If smelling smoke/gas, verify no source exists to prevent accidents while investigating
Common Questions Answered
Get Answers About Phantom Smells
Phantosmia is real and treatable. Our specialists will investigate both peripheral and central causes to find the source of your phantom smells.
Book Your Evaluation