Mutsumi Kuga

Gustatory changes associated with the menstrual cycle.

We studied changes in the palatability and gustatory functions as they correlate with the menstrual cycle in 30 healthy females with regular menstrual cycles. The gustatory function was investigated by conducting electrogustometry and by the filter-paper disk method with taste solutions in the follicular and luteal phases of the same subjects. The responses to a questionnaire revealed that appetite was enhanced prior to menstruation in 14 cases (46.7%). The results of electrogustometry showed that the threshold in the domain of the chorda tympani nerve was 0.3 +/- 3.4 dB in the follicular phase and -0.9 +/- 2.8 dB in the luteal phase. Although the threshold in the luteal phase indicated a statistically significant decrease (p < 0.05), the difference was so small that the change could not be subjectively discriminated. The threshold in the domain of the glossopharyngeal nerve was 2.6 +/- 4.0 dB in the follicular phase and 1.7 +/- 3.9 dB in the luteal phase, with no significant difference between the two values. Gustatory thresholds as obtained by the filter-paper disk testing were not significantly different between the follicular and luteal phases. Thus, although the taste function may change through the menstrual cycle, changes in gustatory thresholds are minimal and remain within the normal range.

Changes in gustatory sense during pregnancy.

Changes in gustatory sense were investigated in 97 pregnant women and in 30 healthy, non-pregnant women who served as controls. All 97 pregnant women completed a questionnaire regarding taste changes and 32 of them underwent serial tests of gustatory function, including electrogustometry and testing with filter paper disks placed over the areas of the chorda tympani nerve and glossopharyngeal nerve. All gustatory testing was performed by the same person. In addition, serum levels of trace elements were measured in 72 of the pregnant women. Of the 97 pregnant women, 90 (92.8%) reported in the questionnaire that they had experienced some type of change in taste during pregnancy, usually a change in sour taste (59 women; 65.6%). Pregnant women had higher gustatory thresholds than non-pregnant women, with an especially marked decrease in gustatory function being noticed in the first trimester. Although serum zinc levels decreased in pregnant women between the second and third trimesters, zinc levels were in the normal range in the early stage of pregnancy. Thus, it is difficult to explain dysgeusia in the early stage of pregnancy as being associated with a deficiency of zinc. The decrease in gustatory function during the first trimester is considered to be due to the notable changes in secretion of hormones that occur during this stage.

A case report of facial nerve palsy associated with chickenpox.

We examined a very unusual patient who developed peripheral facial palsy with chickenpox. A survey of the English literature revealed that eight such patients had been reported, but the period between the appearance of the vesicles of varicella and the facial nerve palsy ranged from five days before to 16 days after the eruption development. We presume that the route of infection was neurogenous in patients who had palsy after the appearance of the eruptions, but haematogenous in patients who had palsy before the appearance of vesicles. The two patients whose infection route was presumed to be haematogenous, had a poor prognosis.

Anti-Borrelia burgdorferi antibodies in patients with facial paralysis

SummaryNinety-eight patients with facial paralysis were studied by an indirect enzyme-linked immunosorbent assay (ELISA) employing two types of Borrelia burgdorferi antigen, namely sonic extract and flagellum protein of B. burgdorferi. IgG or IgM antibodies were detected by sonic extract ELISA in 22 (32.4%) of 68 patients with Bells palsy, and in 2 (10.0%) of 20 patients with varicella-zoster virus infection. This difference was statistically significant (P<0.05). A positive reaction was more frequent with the sonic extract antigen, while the positive rates were significantly increaesd in Bells palsy patients with hyperglobulinemia (P<0.05). IgM antibodies were also significantly more frequently observed in patients who developed Bells palsy between October and March (P< 0.05). Since none of the patients had a history suggestive of Lyme disease, some kind of non-specific reaction and certain undefined factors linked to a positive reaction against B. burgdorferi could be involved in Bells palsy.

Anti-Borrelia burgdorferi Antibodies in Sera of Patients with Facial Paralysis

Borrelia burgdorferi is a pathogenic spirochete which causes Lyme disease mediated by members of the Ixodidae, as discovered in 1982 [1]. Lyme disease is a complex multisystem disorder. Many cases of this disease were found and reported for the first time in Lyme. Connecticut, United States in the latter half of the 1970s [2]. There are reports, particularly from Europe, maintaining that B. burgdorferi, which is the pathogenic spirochete of Lyme disease, is involved in causing Bell’s palsy [3–5]. Cases have also been described in Japan where ECM occurred after a tick bite and the patients were serologially diagnosed as having Lyme disease [6]. It is important therefore to examine the relation between Bell’s palsy and B. burgdorferi in Japan. In the present study, the authors focused on patients residing in or near Toky whose main complaints were associated with facial paralysis.