Elsevier

Revue Neurologique

Volume 163, Issue 2, February 2007, Pages 155-167
Revue Neurologique

Olfaction et pathologies neurologiques : revue de la littératureOlfaction and neurological diseases: a review of the literature

https://doi.org/10.1016/S0035-3787(07)90387-2Get rights and content

Résumé

Les troubles olfactifs sont décrits dans de nombreuses maladies neurologiques. Après un traumatisme crânien, ils sont classiques et souvent irréversibles. Au cours de la maladie de Parkinson, ils sont présents dès les premiers stades de la maladie et mis en évidence par tous les tests comportementaux. Au cours d’autres syndromes parkinsoniens, les capacités olfactives sont atteintes de façon différente. Les déficits sont sévères dans la démence à corps de Lewy, modérés lors d’atrophie multi systématisée et habituellement préservés au cours de la dégénérescence cortico-basale. Dans la maladie d’Alzheimer, les troubles olfactifs sont également fréquents, précoces et s’aggravent lors de la progression de la maladie. Rarement rapportés par les patients, ils nécessitent une évaluation par des tests olfactifs pour être décelés. Même si l’épilepsie est plus connue par ses phénomènes hallucinatoires, des altérations des capacités olfactives sont décrites, notamment lors d’épilepsies temporales. Des troubles de la perception des odeurs sont finalement notés chez les patients atteints de sclérose en plaques et les patients migraineux. Le but de cet article est de faire une revue des principales pathologies neurologiques pouvant être associées à une modification des capacités olfactives et de préciser l’intérêt de ces troubles dans la démarche diagnostique de ces pathologies.

Summary

Olfactory disorders are often misjudged and rarely rated in the clinical setting. They are nevertheless described in a wide range of neurological disorders, and their evaluation can be useful for diagnosis. Usually irreversible olfactory dysfunction is a well-known complication after head trauma. Severe changes in olfactory tests are observed in Parkinson's disease. Dysfunction is present at disease onset and evidenced with all behavioral tests. Regarding other parkinsonian syndromes, olfactory performances are severely impaired in Lewy body disease, less pronounced in multiple system atrophy and usually preserved in corticobasal degeneration. Olfactory deficits are an early feature in Alzheimer's disease and worsen with disease progression. Rarely reported by patients, they must be searched for with olfactory tests. Though epilepsy is mainly known for its olfactory hallucinatory disorders, alterations of olfactory abilities are also described, especially in mesial temporal epilepsy. Disorders of olfactory perception are finally reported in patients with multiple sclerosis and migraine. After a reminder of anatomical data on the olfactory system, and the different methods of testing used to rate olfactory performances, the current review focuses on the type of olfactory dysfunction and damaged brain areas of the olfactory system encountered in the main neurological diseases.

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