Taste loss as an initial symptom of Guillain-Barre syndrome

Abstract

Taste disturbance is a very rare complaint in Guillain-Barre syndrome (GBS) and has only occurred in association with severe facial nerve involvement in advanced cases. [1] We describe the first reported case of ageusia coexisting with sensory trigeminal dysfunction confined to the lingual branch, as the initial symptom of GBS. Ten days after an upper respiratory infection, a 64-year-old previously healthy man developed inability to identify the flavor of foods, accompanied by numbness of both sides of the anterior tongue and perioral region. Two days later, he noted numbness in feet and hands that over the next several days spread to the level of the thighs and midforearms. He also complained of orthostatic light-headedness. On admission eight days after the onset of symptoms, postural hypotension was confirmed (supine blood pressure 130/80, erect blood pressure 80/50). Light touch, pain, and temperature sensations were severely decreased distal to the upper third of the thighs and the midforearms, whereas vibration and position senses were moderately decreased on feet and hands. Deep tendon reflexes were absent, and muscular strength was normal. No abnormalities were detected on examination of both …