1/12. taste and smell disturbance with the alpha-adrenoceptor agonist midodrine.OBJECTIVE: To report a case of a disturbance of taste and smell associated with the alpha-adrenoceptor agonist midodrine. CASE SUMMARY: A 64-year-old white man with autonomic failure was started on midodrine 5 mg/day as treatment for orthostatic hypotension. After 3 months, the dose was increased to 12.5 mg/day, whereupon he noted a new onset of taste and smell disturbance. These symptoms made eating so unpleasant that the man greatly reduced his food intake, leading to significant weight loss. In addition, he experienced well-recognized adverse effects of midodrine, such as scalp pruritus, after the dose increase. All symptoms resolved with a dose reduction of midodrine (to 5 mg/day), and the patient increased his food intake, resulting in a return to his initial body weight. DISCUSSION: midodrine is commonly associated with dose-dependent adverse effects, such as scalp pruritus and cutis anserina. Disorders of taste and smell have not been previously reported with midodrine, although it has been suggested that other sympathomimetic drugs may have effects on the olfactory threshold. Severe disorders of taste and smell may impact not only on a patient's quality of life, but also on their physical well-being, with significant weight loss being reported in this case. According to the Naranjo probability scale, this patient's taste and smell disturbance was probably associated with midodrine. CONCLUSIONS: The use of midodrine may be associated with taste and smell disturbance. This case suggests that such an association is likely to be dose dependent.- - - - - - - - - - ranking = 1keywords = taste (Clic here for more details about this article) |
2/12. Gustatory agnosia.OBJECTIVE: To report the assessment of a patient exhibiting gustatory agnosia. methods: Preoperative and postoperative neuropsychological, neuroimaging, and chemosensory evaluations were performed in a 39-year-old woman undergoing surgical treatment for intractable epilepsy. RESULTS: Preoperative MRIs showed bilateral (right > left) atrophy in the medial temporal lobes and complete atrophy of the left insula. Evaluation of gustatory function revealed normal suprathreshold intensity estimation, affective evaluation, and detection thresholds but elevated recognition thresholds. A functional neuroimaging study showed activation to stimulation of aversive taste in the left amygdala. Surgical treatment entailed resection from the left medial temporal lobe that included the region of amygdala that had responded to taste. Postoperatively, detection, naming, and intensity estimation for taste remained normal, but the patient was unable to recognize different tastes (sweet, sour, salty, and bitter). A second evaluation 2.5 years after her surgery revealed no change in taste ability. CONCLUSION: The anteromedial temporal lobe has an important role in recognizing taste quality.- - - - - - - - - - ranking = 1keywords = taste (Clic here for more details about this article) |
3/12. Rare first symptoms of multiple sclerosis.The most frequent first symptoms of multiple sclerosis are the following: sensory symptoms, optic neuritis, motor and cerebellar syndromes. Three female patients have been diagnosed with multiple sclerosis on the basis of Poser's criteria. The onset of the disease was manifested in these cases with non-typical and rare symptoms. Patient 1, a woman, aged 24. The first symptom of the disease was an isolated lesion of nerve VI on the right side. Patient 2, a women, aged 30. The first symptom of the disease was acute pain localised within the area of the lumbar-sacral spine. Patient 3, a woman, aged 43. The first symptom of the disease was loss of taste and smell.- - - - - - - - - - ranking = 0.16666666666667keywords = taste (Clic here for more details about this article) |
4/12. magnetic resonance imaging findings in the evaluation of traumatic anosmia.OBJECTIVES: Head trauma is a common cause of anosmia, but diagnosis is typically late, owing to more life-threatening sequelae of the injury. Herein, we describe our workup for a case of traumatic anosmia and the magnetic resonance imaging (MRI) findings both at the time of injury and at the 18-month follow-up. methods: We present a case report and a review of the literature. RESULTS: A 33-year-old woman presented to our institution with a chief complaint of loss of smell and taste following an occipital blow to her head that occurred when she was hit by a car while riding a bicycle. We present the findings of MRI performed at the time of the injury and at the 18-month follow-up. We describe the clinical progression of her disease, from symptoms of parosmic and phantosmic episodes accompanied by dysgeusia to total anosmia at the 18-month follow-up. CONCLUSIONS: We advocate the use of MRI, coupled with otolaryngology consultation and formal olfactory testing, in the diagnosis, management, and counseling of patients with anosmia sustained from head injury.- - - - - - - - - - ranking = 0.16666666666667keywords = taste (Clic here for more details about this article) |
5/12. Olfactory and gustatory disturbances caused by digitalism: a case report.It is known that an overdose of digoxin causes visual disturbance, but the effect on the senses of smell and taste is not known. A case of olfactory and gustatory disturbance caused by digitalism is reported. In a 62-year-old male patient suffering from chronic digitalism, the serum digoxin level rose to 6.0 ng/ml. The patient was diagnosed not only with visual disturbance but also hyposmia and hypogeusia. The patient recovered from visual and chemosensory disturbances after the serum digoxin concentration returned to normal. Because the similarity of intracellular signal transduction between photoreceptor cells and olfactory and/or taste receptor cells is known, it is suspected that the influence of digoxin to chemosensory organs was caused by intermediation of sodium-potassium-adenosine triphosphatase (Na-K-ATPase) of the chemosensory receptor cells.- - - - - - - - - - ranking = 0.33333333333333keywords = taste (Clic here for more details about this article) |
6/12. Anosmia after doxycycline use.We report the case of a man who developed anosmia while taking doxycycline tablets for a skin disorder. Two other cases of parosmia occurring in association with doxycycline have been reported to the Adverse Drug Reactions Advisory Committee of the Commonwealth Department of Community Services and health since 1972. Disturbances of taste but not olfaction have been reported with tetracycline use in the past.- - - - - - - - - - ranking = 0.16666666666667keywords = taste (Clic here for more details about this article) |
7/12. An unusual presentation of chronic graft-versus-host disease in an unrelated bone marrow transplantation.The case described is that of an unrelated bone marrow transplantation in a 43-year-old man. Although the major histocompatibility complex met the criteria for a perfect genotypic match, de novo graft-versus-host disease developed with unusual manifestations involving structures of the oral cavity and associated areas. The loss of taste and smell, as well as profound xerostomia, was treated by stimulating salivary flow. Synergistic sialagogues were used with the hope that an increase in salivary production would mediate an improvement in taste and smell.- - - - - - - - - - ranking = 0.33333333333333keywords = taste (Clic here for more details about this article) |
8/12. The effects of loss of taste and smell in a case of anorexia nervosa and bulimia nervosa.A woman with a mixed eating disorder is reported. Her disorder did not remit after a head injury which caused her to lose her sense of taste and smell.- - - - - - - - - - ranking = 0.83333333333333keywords = taste (Clic here for more details about this article) |
9/12. Persistent high-altitude headache and aguesia without anosmia.High-altitude headache and taste dysfunction are usually cured within a few months by descent to sea level. We studied a patient who had persistent bitemporal throbbing headache with the associated findings of high-altitude headache syndrome 15 years after a compression chamber accident. He also had loss of taste without loss of smell since the incident.- - - - - - - - - - ranking = 0.33333333333333keywords = taste (Clic here for more details about this article) |
10/12. Generalized argyrosis in man: neurotological, ultrastructural and X-ray microanalytical findings.Generalized argyrosis can produce a number of abnormalities, including skin discoloration, liver and kidney dysfunction. We describe a patient with generalized argyrosis following long-term self-treatment with oral silver intake, in whom skin discoloration, progressive taste and smell disorders, vertigo and hypesthesia were observed. These findings were confirmed by chemosensory tests and electrophysiological investigations. The development of hypogeusia was assessed by subjective tests, while the progression of hyposmia was followed by recording olfactory evoked cortical potentials. light and electron microscopy of tissue samplings demonstrated electron-dense mineral deposits in basal membranes, in macrophages, in the perineurium of peripheral nerves, along elastic and collagenous fibers, and in necrotic cells of the oral submucosa. silver and sulfur deposits in affected tissues could be defined by X-ray microanalysis. The quantitative ratio between silver and sulfur in involved tissues was similar to that of an inorganic silver-sulfide (Ag2S) standard. The minute increase in the sulfur content when compared to the inorganic standard suggested a sulfur containing organic matrix of the tissue precipitates. Our findings indicate that the affinity of silver for membrane and neuronal structures and the deposition of silver as an insoluble compound (Ag2S) induce the progression of clinical disease.- - - - - - - - - - ranking = 0.16666666666667keywords = taste (Clic here for more details about this article) |
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