Abnormalities of smell and taste have been described in some neurodegenerative diseases including Alzheimer's dementia, idiopathic Parkinson's disease, Huntington's chorea, Korsakoff's syndrome, Pick's disease, the parkinsonian dementia complex of Guam, and amyotrophic lateral sclerosis.1 Hyposmia and hypogeusia are a feature of normal aging but they have not been recorded as a prominent early feature in previous reports of variant Creutzfeldt-Jakob disease (vCJD).2-5 We describe a patient with vCJD whose first symptoms included deficits of taste and smell.

At the time of his initial neurological assessment, this 54 year old ceramic tiler had a 12 month history of loss of taste and smell, anxiety, low mood, and unusually short temper. He first became aware that something was wrong when he lost the ability to differentiate the taste of tea from that of beer. Loss of taste and personality change progressed gradually. He began to crave vanilla ice cream although he had never liked sweet foods in the past. He became …