Relationship Between Dysgeusia and Dysesthesia in Stroke Patients

Abstract

This study investigated the relationship between dysgeusia and dysesthesia in stroke patients and evaluated the effect of carbamazepine therapy. Twenty-four patients with dysesthesia of the face, oral cavity, or tongue were divided into two groups: with and without subjective dysgeusia. Taste thresholds were objectively evaluated using the filter-paper taste test and electrogustometry. There was no significant difference in taste thresholds between the two groups. Carbamazepine had an effect on subjective dysgeusia in four of the eight treated patients. Dysgeusia with dysesthesia in stroke patients might be caused by disorders of the somatosensory pathway rather than disorders of the gustatory pathway.

Altered Taste and Stroke: A Case Report and Literature Review

“…Impaired taste perception can result from lesions in several locations including the pons, insular cortices, and specific thalamic nuclei. 1–10 Several case reports have detailed altered taste as a result of isolated pontine lesions 2–6,10 as well as both isolated right and left insular lesions. 11,12 Deficits including ageusia (inability to taste), hypogeusia (decreased ability to taste), and dysgeusia (distorted ability to taste) have also been described.…”

Altered Taste and Stroke: A Case Report and Literature Review

“…7 This theory is supported by numerous functional MRI studies demonstrating that the insular, parietal, frontal opercular, and orbitofrontal cortical areas are activated with gustatory pathway stimulation. 17,20 It is important to note that damage to the somatosensory pathways may also result in dysgeusia independent of central gustatory pathways, based on findings by Etoh et al, 10 who studied objective dysgeusia (as measured with electrogustometry and filter paper testing) in patients with lesions in the pons, thalamus, putamen, or insula.…”

“…One small study found that carbamazepine improved stroke-induced dysgeusia. 10 Activation of cannabinoid receptors by delta-9-tetrahydrocannibinol has been shown to improve food palatability, thus increasing appetite and food intake, possibly through stimulation of dopamine production in the nucleus accumbens. [43][44][45][46] Future research in this area will be helpful in identifying potential therapies.…”

“…11,12 Deficits including ageusia (inability to taste), hypogeusia (decreased ability to taste), and dysgeusia (distorted ability to taste) have also been described. 7,9,10 Taste perception was initially thought to be processed without decussation, 2 but more recently complete or bilateral decreased perception has been attributed to isolated left insular infarcts, 7,[11][12][13] suggesting that this site may receive contralateral projections or function as an important higher order center for taste perception. Isolated insular infarcts affecting taste are uncommon, and thus the symptoms of altered taste may go unrecognized in patients experiencing larger middle cerebral artery (MCA) territorial infarcts, thereby limiting patient recovery and resulting in worse outcomes.…”

“…Impaired taste perception can result from lesions in several locations including the pons, insular cortices, and specific thalamic nuclei. [1][2][3][4][5][6][7][8][9][10] Several case reports have detailed altered taste as a result of isolated pontine lesions [2][3][4][5][6]10 as well as both isolated right and left insular lesions. 11,12 Deficits including ageusia (inability to taste), hypogeusia (decreased ability to taste), and dysgeusia (distorted ability to taste) have also been described.…”