Ageusia

Ageusia is the loss of taste functions of the tongue, particularly the inability to detect sweetness, sourness, bitterness, saltiness, and umami (meaning "pleasant/savory taste"). It is sometimes confused with anosmia – a loss of the sense of smell. Because the tongue can only indicate texture and differentiate between sweet, sour, bitter, salty, and umami, most of what is perceived as the sense of taste is actually derived from smell. True ageusia is relatively rare compared to hypogeusia – a partial loss of taste – and dysgeusia – a distortion or alteration of taste.[1][2]

Ageusia
Pronunciation
  • /əˈɡjuːziə/ ə-GEW-zee-ə
SpecialtyNeurology

Causes

The main causes of taste disorders are head trauma, infections of upper respiratory tract, exposure to toxic substances, iatrogenic causes, medicines, glossodynia ("burning mouth syndrome (BMS)")[2] and COVID-19.[3]

Head trauma can cause lesions in regions of the central nervous system which are involved in processing taste stimuli, including thalamus, brain stem, and temporal lobes; it can also cause damage to neurological pathways involved in transmission of taste stimuli.

Neurological damage

Tissue damage to the nerves that support the tongue can cause ageusia, especially damage to the chorda tympani nerve and the glossopharyngeal nerve. The chorda tympani nerve passes taste for the front two-thirds of the tongue and the glossopharyngeal nerve passes taste for the back third of the tongue. Neurological disorders such as Bell's palsy, Familial dysautonomia, and Multiple sclerosis cause similar problems to nerve damage, as do certain infectious conditions like primary amoeboid meningoencephalopathy. The lingual nerve (which is a branch of the trigeminal V3 nerve, but carries taste sensation back to the chorda tympani nerve to the geniculate ganglion of the facial nerve) can also be damaged during otologic surgery, causing a feeling of metal taste.

Problems with the endocrine system

Deficiency of vitamin B3 (niacin) and zinc can cause problems with the endocrine system, which may cause taste loss or alteration. Disorders of the endocrine system, such as Cushing's syndrome, hypothyroidism and diabetes mellitus, can cause similar problems. Ageusia can also be caused by medicinal side-effects from antirheumatic drugs such as penicillamine, antiproliferative drugs such as cisplatin, ACE inhibitors, and other drugs including azelastine, clarithromycin, terbinafine, and zopiclone.

Other causes

Local damage and inflammation that interferes with the taste buds or local nervous system, such as that stemming from radiation therapy, glossitis, tobacco use, or the wearing of dentures, can also cause ageusia. Other known causes include loss of taste sensitivity from aging (causing a difficulty detecting salty or bitter taste), anxiety disorder, cancer, kidney failure and liver failure. Recently, 88% of a series of over 400 COVID-19 disease patients in Europe were reported to report gustatory dysfunction (86% reported olfactory dysfunction).[4]

Diagnosis

Both taste and smell disorders are diagnosed by an otolaryngologist, a doctor of the ear, nose, throat, head, and neck. An otolaryngologist can determine the extent of your taste disorder by measuring the lowest concentration of a taste quality that you can detect or recognize. You may also be asked to compare the tastes of different substances or to note how the intensity of a taste grows when a substance's concentration is increased.

Scientists have developed taste testing in which the patient responds to different chemical concentrations. This may involve a simple “sip, spit, and rinse” test, or chemicals may be applied directly to specific areas of the tongue.

References
  1. "Taste Disorders". Massachusetts Eye and Ear Infirmary. Retrieved 30 November 2018.
  2. Hummel, Thomas; Landis, Basile N.; Hüttenbrink, Karl-Bernd (2011). "Smell and Taste Disorders". GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery. 10: Doc04. doi:10.3205/cto000077. PMC 3341581. PMID 22558054.
  3. Al-Ani, Raid M.; Acharya, Debashis (19 August 2020). "Prevalence of Anosmia and Ageusia in Patients with COVID-19 at a Primary Health Center, Doha, Qatar". Indian Journal of Otolaryngology and Head & Neck Surgery: 1–7. doi:10.1007/s12070-020-02064-9. PMC 7435125. PMID 32837952.
  4. Lechien, Jerome R.; Chiesa-Estomba, Carlos M.; De Siati, Daniele R.; Horoi, Mihaela; Le Bon, Serge D.; Rodriguez, Alexandra; Dequanter, Didier; Blecic, Serge; El Afia, Fahd; Distinguin, Lea; Chekkoury-Idrissi, Younes; Hans, Stéphane; Delgado, Irene Lopez; Calvo-Henriquez, Christian; Lavigne, Philippe; Falanga, Chiara; Barillari, Maria Rosaria; Cammaroto, Giovanni; Khalife, Mohamad; Leich, Pierre; Souchay, Christel; Rossi, Camelia; Journe, Fabrice; Hsieh, Julien; Edjlali, Myriam; Carlier, Robert; Ris, Laurence; Lovato, Andrea; De Filippis, Cosimo; Coppee, Frederique; Fakhry, Nicolas; Ayad, Tareck; Saussez, Sven (6 April 2020). "Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study". European Archives of Oto-Rhino-Laryngology. 277 (8): 2251–2261. doi:10.1007/s00405-020-05965-1. PMC 7134551. PMID 32253535.
  • MedTerms Online Medical Dictionary. "Ageusia". Retrieved April 15, 2005.
  • Family Practice Notebook. "Taste Sensation". Retrieved April 15, 2005.
  • Massachusetts Eye and Ear Infirmary. "Taste Disorders". Retrieved May 26, 2010.
Classification
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