Reflex rhinorrhea after a right caudate infarct

Area of Science:

• Neurology
• Neuroscience
• Clinical Medicine

Background:

• Caudate nucleus lesions can manifest with diverse neurological symptoms.
• Reflex rhinorrhea is a rare autonomic response.
• Gustatory-induced autonomic reflexes are not fully understood.

Observation:

• A 57-year-old male patient presented with left-sided reflex rhinorrhea triggered by gustation.
• The patient had a history of right caudate infarct.
• Standard neurological examinations, including blink reflex and facial electrodiagnosis, yielded normal results.

Findings:

• The normal blink reflex and facial electrodiagnosis suggest the observed rhinorrhea is not due to peripheral nerve dysfunction.
• A disinhibitory response originating from the damaged right caudate nucleus is proposed as the mechanism.
• This disinhibition may affect the superior salivatory nucleus, leading to gustatory rhinorrhea.

Implications:

• This case highlights a novel potential pathway for gustatory-induced autonomic responses.
• Understanding caudate nucleus involvement in autonomic reflexes can inform future clinical assessments.
• Further research into disinhibitory mechanisms in brainstem-cranial nerve pathways is warranted.