Hyderabad woman frequently experienced smell of burning incense. Diagnosis: Brain tumour!

These episodes increased in frequency, to the point that it was occurring three times a week.

She would complain of a burning incense smell at different times of day or night, and these symptoms would last only a few minutes.

Her family thought it was God’s message to her to pray with more devotion.

Prayer no solution

“Her mother-in-law asked her to fast for two days every week and offer prayers to God to bless her with good health. But her symptoms persisted despite the prayers. They consulted the village faith healer, on whose instructions, a yagya (special worship) was performed, which too yielded no result,” said the doctor.

He said that on a few occasions, she would appear to be in a trance. “By now, the family was fed up and thought she had gone mad. Radha was taken to a psychiatrist, who ruled out psychopathology,” said the doctor.

On the psychiatrist’s advice, she came to Kumar’s OPD.

“The symptoms were always the same: Smell of burning incense that lasted for a few minutes, typical of olfactory hallucinations. The state of trance was actually altered consciousness,” said the doctor.

He ordered a brain MRI and EEG tests. “When she returned the next day, the MRI showed a tumour in the right medial temporal lobe involving the amygdala. EEG showed epileptiform discharges arising from the right temporal region,” said the doctor.

She was diagnosed with olfactory seizures due to a right medial temporal lobe tumour. She was referred for surgery.

Olfactory seizures, also known as seizures of the sense of smell, can occur as a result of a tumour in the right medial temporal lobe.

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Tumour in temporal lobe

A temporal-lobe tumour is a growth that develops in the temporal lobe of the brain. The temporal lobes are located on either side of the brain, above the ears, and are responsible for several important functions such as memory, hearing, and language.

Location of temporal lobe. (Creative Commons)

This area of the brain is also responsible for processing olfactory information, and can be affected by tumours or other neurological conditions.

These seizures can cause changes in the perception of smell, such as phantom smells or distorted smells.

Treatment for olfactory seizures typically involves addressing the underlying cause, such as removing the tumour or managing the symptoms of the condition.

In some cases, medication may be prescribed to help manage seizures.

“Radha made an excellent recovery and had no further episodes of smelling burning incense or going into a trance after surgery during three months of follow-up,” said the doctor.

He added that people should always be aware of abnormal smell sensations lasting for brief periods, which could be olfactory seizures arising from the temporal lobe of the brain.

“It could be any other smell, too. I have seen other patients who could smell the smoke of burning wood, diesel, and so on,” said the doctor.

“Brain scan and EEG would help in confirming the diagnosis, and the treatment — whether it is medical or surgical, depending on cause — results in excellent outcomes,” said the doctor.

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