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Bilateral hypogeusia in a patient with a unilateral paramedian thalamic infarction
  1. Makoto Nakajima,
  2. Toshiho Ohtsuki,
  3. Kazuo Minematsu
  1. Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, Osaka, Japan
  1. Correspondence to Dr Makoto Nakajima, Department of Neurology, Stroke Center, Saiseikai Kumamoto Hospital, 5-3-1, Chikami, Kumamoto, 861–4193, Japan; nakazima{at}fc.kuh.kumamoto-u.ac.jp

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Compared with other neurological deficits in patients with stroke, clinicians often overlook taste disorders, even though more than 30% of patients with acute stroke have taste disturbances.1 Some authors have reported cases with bilateral taste disorders induced by a unilateral lesion in the brainstem, putamen, insular cortex or the parietal lobe. We present the first case of a bilateral taste disorder due to a unilateral paramedian thalamic infarction.

Case report

A 40s healthy person suddenly developed double vision on downward gaze and transient weakness of the right limbs. After 5 days, the patient became aware of paraesthesia and dullness of taste on both sides of the tongue. On the next day, the patient consulted our hospital and was admitted with a diagnosis of cerebral infarction.

The admission physical examination showed a blood pressure of 110/54 mm Hg, with a regular pulse of 60 beats/min. No abnormal sounds were heard on chest auscultation. On neurological examination, the patient was alert, and the visual fields were full. On downward gaze, the patient complained of double vision due to limitation of the left eye's downward movement. The pupils were isocoric, and both had prompt and complete light reflexes. The patient complained of paraesthesia and dullness …

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