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taste disturbance

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Causes of a taste disturbance to consider include:

  • upper respiratory tract infection - the taste of food is dependent on the smell
  • anosmia
  • glossopharyngeal nerve palsy - loss of taste on the posterior third of the tongue
  • facial nerve palsy
  • chronic adrenal insufficiency - increased sensitivity to the taste of salt, sucrose, urea and other substances

A much more detailed list of causes (1,2,3):

Common causes include:

  • nasal and sinus disease (e.g., allergic or vasomotor rhinitis, chronic sinusitis, nasal polyps, adenoid hypertrophy)
  • upper respiratory infection
  • head trauma (e.g., frontal skull fracture, occipital injury, nasal fracture)
  • cigarette smoking
  • neurodegenerative disease (e.g., Alzheimer's disease, Parkinson's disease, multiple sclerosis)
  • increasing age

Less common causes include

  • drug induced - see linked item
  • cocaine abuse (intranasal)
  • toxic chemical exposure (e.g., benzene, benzol, butyl acetate, carbon disulfide, chlorine, ethyl acetate, formaldehyde, hydrogen selenide, paint solvents, sulfuric acid, thrichloroethylene)
  • industrial agent exposure (e.g., ashes, cadmium, chalk, chromium, iron carboxyl, lead, nickel, silicone dioxide)
  • nutritional factors (e.g., vitamin deficiency [A, B6, B12], trace metal deficiency [zinc, copper], malnutrition, chronic renal failure, liver disease [including cirrhosis], cancer, acquired immunodeficiency syndrome)
  • glossopharyngeal nerve palsy - loss of taste on the posterior third of the tongue
  • facial nerve palsy
  • radiation treatment of head and neck
  • congenital conditions (e.g., congenital anosmia, Kallmann's syndrome)

Uncommon causes include:

  • neoplasm or brain tumor (e.g., osteoma, olfactory groove or cribiform plate meningioma, frontal lobe tumor, temporal lobe tumor, pituitary tumor, aneurysm, esthesioneuroblastoma, melanoma, squamous cell carcinoma)
  • psychiatric conditions (e.g.schizophrenia, depression, olfactory reference syndrome)
  • endocrine disorders (e.g., adrenocortical insufficiency, Cushing's syndrome, diabetes mellitus, hypothyroidism, primary amenorrhea, pseudohypoparathyroidism, Kallmann's syndrome, Turner's syndrome)
  • pregnancy
  • epilepsy (olfactory aura)
  • migraine headache (olfactory aura)
  • cerebrovascular accident
  • Sjögren's syndrome
  • Systemic lupus erythematosus

Reference:

  • Bromley SM. Smell and Taste Disorders: A Primary Care Approach.Am Fam Physician. 2000 Jan 15;61(2):427-436.
  • Prescriber 1999; 10 (12): 94.
  • Pulse 2004; 63 (47): 80.

Links:

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