Taste Disorders (Dysgeusia): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
    • Auscultation (listening) of the heart.
    • Auscultation of the lungs
    • Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, kidney bearing knocking pain?)
  • ENT medical examination including taste test* and “whole mouth testing” using the “three-drop method* * “.
  • Neurological examination incl. cranial nerve functions [due todifferential diagnoses:
    • Apoplexy (stroke)
    • Inflammation of the central nervous system, unspecified
    • Epilepsy (seizure disorder)
    • Familial dysautonomia (Riley-Day syndrome) – disease of the involuntary (autonomic) nervous system.
    • Brainstem lesions – injury, hemorrhage, infarction in the area of the brainstem.
    • Brain tumors, unspecified
    • Idiopathic facial nerve palsy (most common peripheral nerve lesion and by far the most common cranial nerve lesion).
    • Peripheral nerve lesion (especially VII and IX cranial nerves).
    • Multiple sclerosis – neurological disease characterized by demyelination of the central nervous system.
    • Nerve damage – v. a. after surgery on the middle ear, tonsils, throat; dental treatment.
    • Progressive paralysis – late stage of syphilis, which can lead primarily to many different neurological symptoms such as dementia, personality disorders, paresis (paralysis), etc.]
  • Psychiatric examination [due todifferential diagnoses:
    • Depression
    • Psychosis
    • Schizophrenia]
  • Dental examination [due todifferential diagnosis: tumors of the oral cavity, unspecified]
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.

* The taste test usually assesses the perception of sweet (sucrose), sour (citric acid), salty (sodium chloride) and bitter (quinine). The detection thresholds and the identification ability of suprathreshold tastants are determined. The tasting ability is usually tested globally as a “whole mouth test” or regionally in individual gustatory areas. * * Three-drop method according to Henkin is a “whole-mouth testing”. This method is frequently used in practice. It involves determining the detection threshold for sweet, sour, salty and bitter. The patient must recognize the one tasting substance from three drops and correctly name the tasting quality. The subthreshold concentration of tastants is increased until the patient can correctly name the same concentration of a tasting quality at least twice in three attempts.

For detailed information on this topic, see gustometry (taste testing).