A case of olfactory reference syndrome.

An army soldier in his early thirties was referred to the neurology ward with a history of urinary incontinence for the last 2 months. He complained of incontinence of urine and an unpleasant odour of urine which was noted by others as well. He complained that some of the gestures of his colleagues such as wiping their nose, or covering their faces as a response to his unpleasant body odour. He stated that these thoughts occupied most of his waking time although he acknowledged that his thoughts on the odour were excessive and unreasonable. Detailed questioning revealed he was repeatedly checking his underwear for urinary stains and was taking extra baths and wearing additional undergarments which he frequently changed in order to mask the odour. Clinical evaluation revealed that the preoccupation of the smell of urine was what led to him presenting as incontinence and there was no objective evidence of urinary incontinence. Detailed neurological evaluation excluded spinal cord pathology and a contrast enhanced CT of the brain and EEG was normal.