Assessment of taste disorders

periodontitis (loose teeth), dental abscess, necrotising gingivitis

inflamed gingivae, ulcerative or necrotic gingival lesions, mobile teeth, attachment loss (elongated teeth), periodontal pocket, halitosis

taste disturbance immediately follows an upper respiratory tract infection but may present months after onset; often transient

may be normal

taste disturbance of variable onset; history of antifungal therapy (e.g., terbinafine) or antibiotic therapy (e.g., metronidazole); history of antihypertensive treatment with ACE inhibitors

may be normal

recent chemotherapy, use of targeted therapy, immune checkpoint inhibitors, radiation therapy to the head and neck for malignant disease; transient taste disturbance

variable; may be normal; dry mouth/signs of hyposalivation (inflamed mucosa, presence of mucus threads or frothy or bubbly saliva, and tooth decay or loss)

history of recent dental procedure involving mandibular teeth; wisdom tooth removal; patient may complain of numbness of the lower lip; taste disturbance

evidence of dental surgery; mandibular nerve anaesthesia

history of recent tonsillectomy procedure; taste disturbance

absence of tonsils

history of recent middle ear surgery; may complain of dry mouth; taste disturbance

xerostomia; salivary pooling

sudden onset of unilateral facial paralysis; post-auricular or facial pain; acute onset of taste disturbance

dry eye; unilateral facial nerve paralysis

list of current or recent medication (e.g., terbinafine, metronidazole, captopril, cisplatin, etoposide)

variable; may be normal

taste disturbance of variable onset; burning and dryness of mouth worsening as day progresses (bilateral; tongue most, then lips and anterior palate; often decreased when eating)

may be normal

taste disturbance of gradual onset; painless otorrhoea and hearing loss

visible defect tympanic membrane; in-growth of skin of the ear drum; destruction of surrounding middle ear bones

taste disturbance is typically associated with anosmia, and may be accompanied by dry cough, fever, and/or dyspnoea; other common symptoms include fatigue, anorexia, myalgia, and sore throat; may be a travel history to an affected area or close contact with a suspected or confirmed case in the 14 days prior to symptom onset

may have fever and/or dyspnoea; patients with pneumonia or respiratory distress syndrome may have inspiratory crackles, rales, and/or bronchial sounds on auscultation; patients with respiratory distress syndrome may have tachycardia, tachypnoea, or cyanosis accompanying hypoxia

history of recent endoscopy procedure; taste disturbance

may be normal

history of recent oral surgical procedure; taste disturbance immediately following surgery

scarring from surgery

history of recent surgery for an intra-cranial lesion (e.g., neoplasm, aneurysm); taste disturbance immediately following surgery

craniotomy scars apparent

paroxysmal ear pain, vertigo, ipsilateral hearing loss and tinnitus; facial paresis; taste disturbance

vesicles or blisters in the ear canal

acute changes in mental status likely; associated with neurological symptoms: unilateral weakness or numbness; change in vision (unilateral or bilateral); difficulty with speech, comprehension; loss of co-ordination, difficulty walking; severe headache; vertigo; deafness; acute onset of taste disturbance

confusion noted frequently; focal neurological signs include: unilateral hemiparesis, hemianopia, diplopia, aphasia, dysarthria, ataxia, ageusia or hemiageusia

acute onset of taste disturbance; history of head injury, headache, lethargy, and loss of consciousness after head injury (subdural haematoma)

altered level of consciousness; slurred speech; hemiparesis (subdural haematoma); ageusia or hypogeusia

taste disturbance of gradual onset; shaking, stiffness, slowness or poverty of movement; anxiety; apathy; falls; hyper-somnolence; bowel and bladder dysfunction

tremor at rest, rigidity on passive movement; bradykinesia (slowness of movement), poverty of movement (hypokinesia); speech impairment; excess saliva; shuffling, short-stepped gait; orthostatic hypotension and postural instability

taste disturbance of gradual onset; insidious onset of cognitive decline; slow progression; social withdrawal; paranoia or anxiety

primitive reflexes; rigidity; bradykinesia; abnormal speech and posture

taste disturbance of gradual onset; muscle weakness; respiratory dysfunction

pathological hyper-reflexia; spasticity; extensor plantar response; weakness; muscle atrophy; fasciculations and cramps

taste disturbance of gradual onset; variable motor, speech, sensory, gait, or visual dysfunction

spasticity and hyper-reflexia; optic neuritis; intra-nuclear ophthalmoplegia; dysarthria; taste test may be normal or altered (depending on location of the plaques)

bizarre smells; unusual sensations or experience (rising epigastric experience, fear, deja vu, or an 'out-of-body' sensation); witnessed seizure activity; postictal drowsiness; taste disturbance

may be normal

taste disturbance of gradual onset; weakness worsened by fatigue, stress, and exertion

ptosis; muscle weakness

acute onset of taste disturbance; rapid symptom progression; often occurs 1 to 3 weeks after a respiratory or gastrointestinal illness; paraesthesias often precede the onset of weakness; ascending paralysis most common

diffuse weakness (proximal and distal muscle groups); globally reduced or absent reflexes; sensory impairments may be mild; normal sphincter function

dry eyes and mouth; blurred vision; difficulty swallowing food; cracking of lips and corners of the mouth; arthralgias; dry skin; cough; taste disturbance

conjunctivitis; mucus threads; frothy or bubbly saliva; angular cheilitis; tooth decay/loss; parotid and/or submandibular gland enlargement; dry or inflamed mucosa

fatigue; decreased urine output; discoloured urine; vomiting; seizures; taste disturbance of gradual onset

hypertension; oedema; pericarditis

taste disturbance of gradual onset; history of advanced liver disease from any cause, including alcohol, fatty liver, autoimmune causes, and infectious causes

stigmata of chronic liver disease may be present, including spider angioma, palmar erythema, jaundice, and ascites

taste disturbance of gradual onset; may have had type 1 or type 2 diabetes mellitus for many years; polyuria and polydipsia; weight loss; may have blurred vision

retinopathy; peripheral neuropathy; orthostatic hypotension; scars of subcutaneous insulin administration

taste disturbance of gradual onset; fatigue and lethargy; cold intolerance; dyspepsia symptoms; dry skin; constipation; weight gain; paraesthesias; galactorrhoea

hair loss; delayed reflexes; goitre; low resting heart rate; peri-orbital puffiness; delayed ankle deep-tendon reflexes; cold and coarse skin

unexplained headache; change in vision or motor function; poor co-ordination, unsteadiness; seizures; nausea, vertigo; sudden deafness; taste disturbance of gradual onset

focal neurological abnormalities; gaze-evoked nystagmus; ocular flutter; non-specific deficits in balance and gait; normal taste or hemiageusia

weight loss; night sweats; known malignancy (in particular, small cell lung cancer); taste disturbance of gradual onset

lymphadenopathy; cachexia

fatigue; dyspnoea on exertion; altered appetite (pica); taste disturbance of gradual onset

pallor; koilonychias; glossitis

fatigue; dyspnoea on exertion; history of gastrointestinal disorder (e.g., pernicious anaemia, Crohn's disease, gastric surgery); taste disturbance of gradual onset

pallor, glossitis

no special history; taste disturbance of gradual onset

may be normal