A young woman’s recurring complaint of ‘smelling rotten eggs’, initially dismissed by those around her as psychological, was actually the first sign of a hidden brain tumour, a Hyderabad neurologist revealed.
Event Context
Dr Sudhir Kumar, a neurologist at Apollo Hospitals, Hyderabad, shared a case study on X on July 28 to raise public awareness of subtle neurological symptoms. Also read | When a headache is more than ‘just stress’: Neurologists share brain tumour symptoms that often go unnoticed for months
After a psychological evaluation ruled out anxiety, depression, or any psychiatric illness, the mystery remained unsolved until a major neurological event occurred. One morning, following a sudden episode of the smell, the patient became unresponsive for about five minutes, staring blankly and losing awareness of her surroundings before waking up confused.
Team Analysis
The family rushed her to the neurology clinic, where Dr Kumar recognised the symptom as phantosmia — an olfactory hallucination generated inside the brain rather than the environment.
“The rotten egg smell was unlikely to be coming from the environment. It was being generated inside her brain,” Dr Kumar explained, noting that the patient was experiencing olfactory hallucinations, or phantosmia. “Unlike visual or auditory hallucinations associated with psychiatric disorders, olfactory hallucinations often have an organic neurological cause. One important cause is temporal lobe epilepsy,” he added. Also read | Doctor shares ‘weirdest symptom of perimenopause’ that many women often ignore: ‘Ever smelled smoke or chemicals?’
Dr Kumar noted that the brief, repetitive nature of the episodes pointed toward focal aware seizures, which eventually progressed to a seizure that impaired her consciousness. Subsequent diagnostic tests reportedly confirmed the underlying cause. An MRI scan revealed a mass in the patient’s left medial temporal lobe—the region responsible for processing smell, memory, and emotions — while an electroencephalogram (EEG) confirmed abnormal electrical activity originating from the same area.
“The tumour was triggering seizures, and the earliest manifestation of those seizures was the perception of a foul smell,” Dr Kumar said, adding, “Many people associate epilepsy only with dramatic convulsions. In reality, seizures can present in surprisingly subtle ways.”
Following consultation with a neurosurgical team, the patient underwent surgery to remove the mass. Pathology results confirmed the tumour was a low-grade glioma, a slow-growing and treatable primary brain tumour common in young adults when caught early. She was also placed on anti-seizure medication.
Six weeks post-surgery, the patient reportedly returned for a follow-up appointment, entirely free of symptoms. “No more rotten eggs, Doctor,” she told Dr Kumar during the visit, he shared. Also read | Neurosurgeon explains gliomas as actor Kelley Mack dies at 33 after brain tumour battle: Symptoms and treatment
Reflecting on the case, Dr Kumar said that while brain tumours are an uncommon cause of smell distortion, persistent or stereotyped olfactory hallucinations — such as smelling burning rubber, smoke, or rotten eggs — warrant medical attention.
“Olfactory hallucinations are uncommon, but they should never be ignored, especially when they occur repeatedly, are stereotyped, or are accompanied by episodes of altered awareness,” Dr Kumar advised.
He added, “Persistent or recurrent unexplained olfactory hallucinations deserve evaluation by a neurologist, especially if they are associated with staring spells, memory lapses, confusion, involuntary movements, or loss of consciousness.”
Dr Kumar shared that the case highlighted a fundamental lesson in clinical medicine: “The diagnosis often begins not with sophisticated technology, but with listening carefully to the patient. Sometimes, a symptom that everyone else dismisses as ‘all in the mind’ may actually be the brain’s first cry for help.”
Dr Sudhir Kumar is a neurologist based in Hyderabad, Telangana, with 26 years of experience in the field. His qualifications include an MBBS and a DM in neurology. Dr Kumar is known for treating neurological disorders and for providing both clinical care and patient education.
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This article is for informational purposes only and not a substitute for professional medical advice.
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According to Dr Kumar, the 23-year-old patient had been experiencing brief, recurrent episodes of foul odour for six months. “I know nobody believes me,” the patient told Dr Kumar during her consultation. She reportedly added, “But I can smell rotten eggs. It comes suddenly, lasts for about a minute, and then disappears.”
Her family initially suspected environmental factors or a psychological issue, especially since the young woman had a personal dislike for eggs. “She keeps saying this every week,” her father told the doctor, adding, “Nobody else can smell anything.”
