少见的是,味觉倒错或其他味觉功能障碍可能预示某些致命性疾病的存在,如肌萎缩侧索硬化[20]Petzold GC, Einhäupl KM, Valdueza JM. Persistent bitter taste as an initial symptom of amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry. 2003;74:687-688.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1738429/pdf/v074p00687a.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/12700324?tool=bestpractice.com或重症肌无力。在这些病例中,味觉障碍多和言语障碍、发声困难或构音障碍同时存在。[6]Landis BN, Lacroix JS. Taste disorders. B-ENT. 2009;5(suppl 13):123-128.http://www.ncbi.nlm.nih.gov/pubmed/20084813?tool=bestpractice.com
对于伴有其他神经系统症状的味觉障碍患者应格外注意。建议通过颅脑CT或MRI来排除一些中枢神经系统病变(如肿瘤、卒中或多发性硬化等)。[27]Heckmann JG, Heckmann SM, Lang CJ, et al. Neurological aspects of taste disorders. Arch Neurol. 2003;60:667-671.http://archneur.jamanetwork.com/article.aspx?articleid=784121http://www.ncbi.nlm.nih.gov/pubmed/12756129?tool=bestpractice.com
“甜味”功能缺失可能提示某些副肿瘤性疾病(如肺癌,胸腺瘤等)。[33]Panayiotou H, Small SC, Hunter JH, et al. Sweet taste (dysgeusia): the first symptom of hyponatremia in small cell carcinoma of the lung. Arch Intern Med. 1995;155:1325-1328.http://www.ncbi.nlm.nih.gov/pubmed/7778965?tool=bestpractice.com血清电解质可能提示低钠血症。在这种情况下,需要对患者行胸部X线和/或CT扫描。