[Taste disorders as side effects of drug therapy].
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Adult↗
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Disorders of taste and smell.
Symptoms of disorders in taste and smell range from loss of the sensations to an increased sensitivity. Causes include infections, metabolic disorders, and central nervous system disturbances. In many instances, the diagnosis for these disorders is obvious, such as an upper respiratory tract infection. In some cases, the diagnosis eludes the clinician and no pathologic condition is found. For the idiopathic taste disorders, zinc therapy is available; however, no therapy exists for idiopathic smell disorders.
Adolescent↗
Disorders of taste.
At least 2 million Americans suffer with chemosensory dysfunction or disorders of taste and smell. In addition to the obvious aesthetic deprivation, loss of taste may affect an individual's health and psychosocial situation. Most taste disorders are associated with antecedent upper respiratory infection, trauma, or allergic rhinitis, or have an idiopathic etiology. They may reflect underlying neoplastic, neurologic, endocrine, infectious, or nutritional disturbances; only 1% of these patients have a functional disorder. Evaluation consists of a history and physical, followed by a screening test battery searching for any of the treatable etiologies. One third of patients will respond to exogenous zinc therapy after a treatment period of 2 to 4 months. The remainder must rely on supportive measures such as additives, flavor enhancers, and rinses.
Humans↗
Drug-induced disorders of taste.
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Adverse Drug Reaction Reporting Systems↗
[Disorders of taste and smell in alcoholics undergoing detoxification therapy].
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Adult↗
[Evaluating function and disorders of taste].
In a first anatomical section the peripheral gustatory pathways, their central connections, nuclei and cortical projections are discussed. It is evident, that the gustatory fibres from the posterior part of the tongue run in the IX nerve and those from the soft palate reach the medulla oblongata via the petrosal and facial nerve. For the anterior part of the tongue there obviously exists only one gustatory pathway via the chorda tympani-facial nerve. About the further central pathways of taste fibres is much less known. In a second part the methods of taste testing with different taste solutions and the electrogustometry are described. Their practical use and the pitfalls of testing are considered. The disorders of the taste sense compose a third part. Genetic and endocrine abnormalities as well as the side effects of drugs and radiotherapy and the destruction of taste nerves may lead to gustatory deviations. The possibility of central gustatory disorders, especially the combined loss of taste and smell as a result of trauma are mentioned. A chapter dealing with the therapy of taste disorders and a short outlook on the genetic aspects of this oral sense complete this review.
Afferent Pathways↗
Taste impairment and related factors in type I diabetes mellitus.
To study taste in type I (insulin-dependent) diabetes mellitus, 57 consecutive diabetic outpatients (mean +/- SE duration of diabetes 11.4 +/- 0.4 yr) and 38 control subjects were screened for taste disorders with electrogustometry and chemical gustometry. Both groups were comparable for all subject characteristics except body mass index, which was higher in the diabetic group (P less than .05). A taste impairment was found in the diabetic group relative to the control group with electrogustometry (mean threshold 184.3 +/- 15.8 vs. 58.7 +/- 9.2 microA; P less than .001) and chemical gustometry (mean score 13.2 +/- 0.7 vs. 17.1 +/- 0.8; P less than .001). Hypogeusia was found among 73% of the diabetic patients versus 16% of the control subjects (P less than .001). The four primary tastes were involved in taste impairment. With multivariate analysis, taste disorders were related to diabetic status and tobacco and alcohol consumption. In the diabetic group, taste impairment was significantly associated with complications and duration of disease. With multivariate analysis, peripheral neuropathy had the strongest association with taste disorders. These results suggest that taste is impaired during the course of type I diabetes mellitus and that taste impairment could be a complication of the disease. A mechanism of the neuropathic type could be involved.
Adult↗
Disorders in taste and smell.
Although many conditions and medications have been associated with chemosensory disturbances, data from major chemosensory clinical research centers support three major disorders as being causative: nasal and paranasal sinus disease (21%), post-upper respiratory tract viral infection (19%), and head trauma (14%). Despite extensive evaluation, 22% of patients do not demonstrate identifiable causation.
Craniocerebral Trauma↗
Assessment of patients with taste and smell disorders.
The evaluation of patients with taste and smell complaints is difficult without standardized quantitative methods of assessment. This paper summarizes recent developments in the evaluation of chemosensory patients. Evaluation must begin with a careful medical history, since certain questions can help in establishing an etiology. Several recent advances have been made in the development of standardized tests for the assessment of taste and olfactory function. Smell can be evaluated with a combination of butanol threshold and odor identification (University of Connecticut test battery) and with the University of Pennsylvania Smell Identification Test (UPSIT). Scores obtained from 91 patients show good correlation between these two testing procedures. Both tests provide normative data for comparison, with the UPSIT including both age- and sex-related norms. Traditional evaluation of taste deficits with threshold procedures has been questioned. Measures of suprathreshold taste intensity require the anchoring of taste judgements to another, presumably normal, modality. This has been approached using magnitude matching, in which taste and auditory loudness are judged on the same scale. Spatial testing of the tongue and soft palate can reveal pathology of the gustatory nerves or their central connections. Further understanding of taste and olfactory dysfunction will be facilitated by the development of standardized methods of evaluation.
Humans↗
[Gustatory disturbances as sideeffect of medical treatment (author's transl)].
A review of the pharmacological induced taste disorders is given. Many patients complain only of a spontaneous metallic, bitter or salty sensation in their mouths. More serious is the development of a dissociated hypogeusia or even an ageusia. 7 cases with gustatory disturbances caused by orally given medicine are presented. The phenylbutazone, oxyphedrine, carbamazepine, Muskel-Trancopal comp. (Chlormezanon, Paracetamol) and Lioresal (baclofen) were accused to have caused a partial or complete loss of taste. After the treatment had been discontinued it took weeks or even months for a complete recovery.
Acetaminophen↗
Anorexia nervosa responding to zinc supplementation: a case report.
An emaciated 16-year-old female with anorexia nervosa was hospitalized for treatment of vomiting, epigastralgia and diarrhea. The finding of a taste disorder, low serum alkaline phosphatase activity and relatively low serum zinc level strongly suggested a zinc deficiency. Zinc was initially administered intravenously (40 mumol/day) for 7 days, then orally (15 mg elemental zinc/day) for about 60 days. Her digestive symptoms disappeared after the second day of intravenous treatment and she began to gain weight. She rapidly regained her normal weight after one month of receiving the oral zinc supplementation. Both exocrine pancreatic function and intestinal absorption were improved by the prolonged oral administration of zinc. In such cases zinc supplementation may be a therapeutic option in addition to psychologic and other approaches to management.
Adolescent↗
Taste and smell disorders: part 2.
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Humans↗
[Taste in healthy subjects. Influence of alcohol and tobacco consumption].
To define the factors which may affect gustatory function, 42 healthy subjects, without any apparent taste disorder were randomly selected and investigated by electro-gustometry and chemical gustometry. A deterioration in taste discrimination was noted in drinkers in comparison with non-drinkers, both on electro-gustometry, mean threshold (SEM: 88.0 +/- 26.5 versus 47.4 +/- 7.3 microA; p less than 0.05), and also on chemical gustometry (15.1 +/- 2.1 versus 17.4 +/- 0.7; p = 0.05) and also in smokers compared with non smokers (mean of electrical thresholds SEM 104.2 +/- 22.8 versus 38.3 +/- 5.2 microA; p less than 0.01, mean of chemical scores SEM 14.3 +/- 1.1 versus 17.9 +/- 0.9; p less than 0.05). Multivariate analysis demonstrated the influence of the two factors alcohol and tobacco on taste, evaluated by electrogustometry (R2 = 0.36) or chemical gustometry (R2 = 0.28). These results suggest that alcohol and tobacco are liable to influence gustatory function in healthy subjects thereby suggesting that this influence should be taken into account using a corrective factor.
Adult↗
Initial otolaryngologic assessment of patients with taste and smell disorders.
Patients are often referred to otolaryngologists to evaluate dysfunctions of taste or smell. A history and physical examination focused on signs and symptoms of chemosensory disorders, in combination with screening tests for taste and smell function, can quickly and easily delineate the general type and cause of the dysfunction. Several centers for chemosensory disorders referred to in this issue are available for referral to patients who need detailed testing and evaluation. Although treatment options for most taste and smell dysfunctions are limited, by categorizing disorders, we can give the patient an idea of the probable cause and prognosis of the dysfunction.
Humans↗
Factors related to the electric taste threshold in type 1 diabetic patients.
To specify the factors related to taste function in Type 1 diabetes mellitus, 50 diabetic out-patients and 50 control subjects paired for age and sex were screened for taste disorders. None of them consumed significant amounts of alcohol, smoked, or had disease or took drugs capable of altering taste. Taste was studied with electrogustometry, retinopathy was detected by fluorescein angiography, nephropathy by measurement of albuminuria and microalbuminuria, peripheral neuropathy by electroneurography and electromyography, and autonomic neuropathy by cardiovascular function tests. The electrogustometric threshold was, on average, significantly higher in the diabetic group (133 +/- 30 microA) than in the control group (29 +/- 9 microA; p less than 0.001). Electric hypogeusia (electrogustometric threshold greater than 100 microA) was found among 54% of the diabetic patients vs 2% of the control subjects (p less than 0.001). In the diabetic group, the electrogustometric threshold was associated with complications of diabetes, especially with peripheral neuropathy (210 +/- 24 vs 90 +/- 22 microA; p less than 0.001) and microalbuminuria (185 +/- 25 vs 86 +/- 21 microA; p less than 0.01). It was correlated with age (r = 0.37; p less than 0.01) and duration of diabetes (r = 0.52; p less than 0.001) but not with HbA1c (r = -0.04). Using multivariate analysis, duration of diabetes and peripheral neuropathy had the strongest association with taste impairment. These results support previous findings, suggesting that taste impairment is a degenerative complication of diabetes mellitus.
Adult↗
Clinical characteristics of taste and smell disorders.
Chemosensory problems can have major consequences for those patients who develop them. Although more than 200 conditions and 40 medications have been linked to taste and smell disorders, for most patients the cause will fall into one of the following categories: nasal/sinus disease, idiopathic, postviral URI, and head trauma. Careful attention to clinical characteristics will aid immensely in the diagnosis. Parosmias, dysgeusias and the burning mouth syndrome are symptoms that deserve special consideration.
Chemoreceptor Cells↗
[Post-influenza parageusia].
A case of postinfluenzal qualitative taste disorders lasting over two years was described. After short treatment subjective symptoms subsided completely and the results of the gustometric tests normalized themselves.
Adult↗