Landis B N, Leuchter I, San Millán Ruíz D, Lacroix J-S, Landis T
Rhinology-Olfactology Unit, Department of Otolaryngology, University Hospital of Geneva, Switzerland.
J Neurol Neurosurg Psychiatry. 2006 May;77(5):680-3. doi: 10.1136/jnnp.2005.086801.
Knowledge of human central taste pathways is largely based on textbook (anatomical dissections) and animal (electrophysiology in vivo) data. It is only recently that further functional insight into human central gustatory pathways has been achieved. Magnetic resonance imaging studies, especially selective imaging of vascular, tumoral, or inflammatory lesions in humans has made this possible. However, some questions remain, particularly regarding the exact crossing site of human gustatory afferences. We present a patient with a pontine stroke after a vertebral artery thrombosis. The patient had infarctions in areas supplied by the anterior inferior cerebellar artery and showed vertical diplopia, right sided deafness, right facial palsy, and transient hemiageusia. A review of the sparse literature of central taste disorders and food preference changes after strokes with a focus on hemiageusia cases is provided. This case offers new evidence suggesting that the central gustatory pathway in humans runs ipsilaterally within the pons and crosses at a higher, probably midbrain level. In patients with central lesions, little attention has been given to taste disorders. They may often go unnoticed by the physician and/or the patient. Central lesions involving taste pathways seem to generate perceptions of quantitative taste disorders (hemiageusia or hypogeusia), in contrast to peripheral gustatory lesions that are hardly recognised as quantitative but sometimes as qualitative (dysgeusia) taste disorders by patients.
对人类中枢味觉通路的了解主要基于教科书（解剖学解剖）和动物（体内电生理学）数据。直到最近，才对人类中枢味觉通路有了进一步的功能认识。磁共振成像研究，尤其是对人类血管、肿瘤或炎症性病变的选择性成像，使这成为可能。然而，一些问题仍然存在，特别是关于人类味觉传入的确切交叉部位。我们报告一名因椎动脉血栓形成后发生脑桥卒中的患者。该患者在小脑前下动脉供血区域出现梗死，并表现出垂直性复视、右侧耳聋、右侧面瘫和短暂性偏侧味觉丧失。本文回顾了关于卒中后中枢味觉障碍和食物偏好变化的稀少文献，重点关注偏侧味觉丧失病例。该病例提供了新的证据，表明人类中枢味觉通路在脑桥内同侧走行，并在更高水平（可能是中脑水平）交叉。在中枢病变患者中，味觉障碍很少受到关注。它们可能常常未被医生和/或患者注意到。与周围味觉病变不同，涉及味觉通路的中枢病变似乎会产生定量味觉障碍（偏侧味觉丧失或味觉减退）的感觉，而周围味觉病变患者很难将其识别为定量味觉障碍，有时会将其识别为定性（味觉异常）味觉障碍。
