Lateralized normosmia in a patient with Kallmann's syndrome.

Background: Kallmann's syndrome (KS) was first mentioned in 1944 as an asso ciation of anosmia and hypogonadotropic hypogonadism. Causes are multiple g enetic defects the most common of which is the x-linked KS appearing mostly in men. However, autosomal dominat and autosomal recessive forms have also been described. Patient: We present a case of KS with normosmia (male, 39 years of age). All symptoms of hypogonadotropic hypogonadism were present. Results: Psychophysical olfactory testing revealed left-sided anosmia with right-sided normosmia which was confirmed by electrophysiological measures of olfactory function. Magnetic resonance imaging indicated aplasia of the left olfactory tract and bulb, whereas the right-sided structures appeared to be normal. Conclusions: As indicated in this case with lateralized anosm ia and contralateral normosmia, overall olfactory function strongly depends on the "best" nostril. Therefore, in many clinical situations, lateralized olfactory testing appears to be extremely important.