Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Gustatory disturbance associated with putaminal hemorrhage

Akiko Imamura, M.D., Tomohiko Kusuhara, M.D., Masasi Nakajima, M.D., Masayuki Tuji, M.D. and Tatsuo Yamada, M.D.

5th Department (Neurology) of Internal Medicine, Fukuoka University School of Medicine

48-year-old left-handed man experienced a sudden loss of taste, followed by dysarthria and dysphagia. Taste threshold examined by a small filter-paper disc method was severely elevated on both sides of the tongue. Brain CT revealed right putaminal hemorrhage that measured 9.3 ml in volume. In addition, brain MRI showed multiple cerebral infarcts bilaterally in the basal ganglia, and the corona radiata, and on the right side of the middle pontine tegmentum. His dysarthria and dysphagia seemed to be caused by interruption of bilateral cortico-bulbar tracts, and resolved within two weeks when edema around the hemorrhage regressed. The gustatory disturbance that persisted may be caused by the interruption of central gustatory pathways at the pons on one side, and subcortically close to the insular cortex on the other side.

(CLINICA NEUROL, 42: 750|753, 2002)
key words: taste perception, pseudobulbr palsy, putaminal hemorrhage, pontine tegmentum, MRI

(Received: 26-Apr-02)