[Bilateral ageusia after left insular and opercular ischemic stroke]

Gustatory disorders after ischemic stroke is an uncommon event, generally occurring unilaterally, ipsilateral or contralateral to the stroke depending on the site of the lesion. We report a patient who developed bilateral agueusia after a unilateral insular stroke. This 70-year-old right-handed man developed a sudden onset left opercular syndrome in March 1999 with right hemiphyosethesia. Magnetic resonance imaging revealed a left insular and opercular stroke. Anarthria, swallowing and sensorial disorders regressed in a few weeks, but taste disturbances led to a 6 kg weight loss. After six months, the symptoms disappeared. To our knowledge, 32 cases of taste disorders after stroke have been reported. For most of the cases, the agueusia was unilateral. Our case illustrated the predominance of the left cortical hemisphere for taste perception in the right-handed subject.