309 - Altered taste following pontine cerebrovascular accident (CVA); A case report

Thursday, February 19, 2026

5:00 PM - 6:30 PM AST

Co-Author(s)

BS

Brijesh Sharma, DO

Resident
Stanford University
Fremont, California, United States

Presenting Author(s)

RL

Royce Le, BS

MS4
University of Virginia
Chalottesville, Virginia, United States

Co-Author(s)

PV

Priya Varma, MD, MPH

Attending Physician
Santa Clara Valley Medical Center
San Jose, California, United States

Submitter(s)

BS

Brijesh Sharma, DO

Stanford University
Fremont, California, United States

Case Diagnosis: 58-year-old male with new taste disturbance after presenting with gait disturbance and dysmetria secondary to subacute left pontine cerebrovascular accident (CVA).

Case Description: A 58-year-old male presented to the hospital with right-sided gait disturbance and dysmetria and was found to have a subacute left pontine CVA. During inpatient rehabilitation, the patient developed a “poisonous” taste at the anterior 2/3rd of his tongue, leading to food aversion and poor oral intake. A broad differential diagnosis was investigated, including possible gastric reflux, vitamin and mineral deficiencies, and medication side-effects, which were unrevealing. The patient's taste began to improve spontaneously one week following the onset of symptoms.

Discussions: Taste disturbance has been described in case reports as a potential sequelae of pontine CVA, usually characterized as hypogeusia and dysgeusia. In the setting of pontine stroke, the chorda tympanic fibers and possibly the solitary tract, components of the gustatory pathway, can be disrupted, leading to taste dysfunction. In these prior case reports, patients have described their symptoms as a metallic taste in the mouth or a general aversion to food. Consequences of oral aversion are broad and can include nutritional deficiencies, poor endurance, acute kidney injury and impaired functional abilities. This can impact a patient’s recovery and can predispose them to further complications. The prognosis for stroke-related taste disturbance is generally favorable, with most cases resolving within several months of onset.

Conclusions: Alteration in taste is an underrecognized symptom of pontine stroke. Symptoms may present as a metallic or toxic taste in the mouth. Physiatrists need to recognize hypogeusia and dysgeusia as a possible sequelae of pontine strokes, which can lead to poor oral intake, malnutrition, and further complications.