Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of successful treatment with donepezil of olfactory hallucination in parkinson disease

Osamu Osada, M.D.1) and Akira Iwasaki, M.D.1)

1)Department of Neurology, Fukaya Red Cross Hospital

We report a 74-year-old female patient with Parkinson disease (PD). Around 2010, she developed depression and bradykinesia and was diagnosed as PD. In July 2014, she came to our hospital, of which she lived in the neighborhood. In the last part of December 2014, she felt uneasy about her fecal smell and saw a psychiatrist in the first part of January 2015. Quetiapine (25 mg/day) was added. In the last part of January, she complained of fecal smell everywhere and could not take a meal. No-one else could detect the smell. A diagnosis of olfactory hallucination was made. The next day after increasing to 75mg/day, however, she was admitted to our hospital because of refusing to take medicine. After introducing donepezil, olfactory hallucination subsided and her appetite was improved. Brain MRI showed atrophy of the bilateral temporal lobes and N-isopropyl-p-(iodine-123)-iodoamphetamine single photon emission computed tomography (123I-IMP-SPECT) revealed hypoperfusion in the bilateral mesial temporal lobes. We suppose that cholinergic denervation in the mesial temporal lobes is an important determinant of her olfactory hallucination.
Full Text of this Article in Japanese PDF (581K)

(CLINICA NEUROL, 57: 29|32, 2017)
key words: olfactory hallucination, Parkinson disease, donepezil, brain MRI, 123I-IMP-SPECT

(Received: 10-May-16)