Testing loss of smell in brain injury claims can provide valuable objective evidence when a claimant reports anosmia or reduced olfactory function following neurological trauma. Although smell loss may initially appear to be a relatively narrow symptom, olfactory dysfunction can occur following traumatic brain injury (TBI) and may form part of a broader pattern of neurological, cognitive and functional change.
For solicitors, the important question is therefore not simply whether loss of smell has been reported, but how that complaint can be assessed and interpreted within the wider clinical evidence.
Can Loss of Smell Be Objectively Tested?
Smell is subjective as an everyday experience, but olfactory function can be examined using standardised psychophysical measures.
Validated approaches can assess different components of olfaction, including odour identification, discrimination and detection threshold. This is important because relying solely on a claimant’s description of their smell difficulties may provide an incomplete picture.
As with neuropsychological measures more broadly, however, a test score should not be interpreted in isolation. Test selection, normative data, cultural familiarity with odours and the wider clinical context can all influence interpretation.
Why Can Smell Be Affected After Brain Injury?
Traumatic injury can disrupt olfactory functioning through several mechanisms, including damage involving olfactory pathways and brain regions contributing to the processing of smell.
This means reported smell disturbance may be clinically relevant in a brain injury assessment, particularly when considered alongside other neurological, cognitive or behavioural findings.
The nature and mechanism of the injury, medical records, imaging where available, symptom history and assessment findings may therefore all contribute to understanding the reported impairment.
Where Does Neuropsychological Evidence Add Value?
For a Neuropsychologist, the value is not simply in establishing whether somebody can identify an odour.
Where olfactory assessment falls appropriately within the expert’s competence, findings can be considered alongside the claimant’s broader neuropsychological profile. This may include cognition, behaviour, symptom reporting and everyday functioning.
Loss of smell can also have consequences extending beyond sensory experience. It may affect enjoyment of food, recognition of environmental hazards, daily routines and quality of life.
Importantly, specialist ENT or other medical evidence may also be required where questions concern peripheral olfactory pathology, diagnosis or medical management. The appropriate expertise should always reflect the specific medico-legal question.
Neuropsychological Expertise Through Medico-Legal Healthcare
At Medico-Legal Healthcare, we provide access to experienced Neuropsychologists for complex brain injury claims where cognitive, behavioural and functional consequences require specialist assessment. Where reported olfactory change forms part of that wider presentation, appropriately selected neuropsychological evidence can help place objective assessment findings within the broader consequences of neurological injury.