单纯味觉障碍与丘脑腔隙性脑梗死

目的分析丘脑腔隙性脑梗死与味觉障碍之间的关系。方法对7例主诉味觉障碍的患者进行临床检查、味觉检查及头MRI检查。结果 7例患者味觉检查均表现一侧味觉（甜、咸、酸、苦）消失,头MRI均证实丘脑腹内侧下部有腔隙性梗死灶,病灶位于味觉缺失对侧2例,病灶位于味觉缺失同侧5例。结论 （1）临床上重视单纯性味觉障碍的症状与查体,结合头MRI检查,可以确诊;（2）本文多数病例证实了味觉传导路具有同侧上行的特点,即从孤束核发出的味觉二级纤维在同侧脑干网状结构内上行到达丘脑腹侧后内核小细胞群（VPMpc）;（3）头MRI冠状位的检查异证实VPMpc病变的部位及程度;（4）丘脑腔隙性脑梗死导致的单纯味觉障碍有可恢复性。

The relationship between dysgeusia and lacuna infarction of thalamus

Objective To analyze the relationship between lacuna infarction of thalamus and dysgeusia. Methods Physical examination of the central nervous system （ including gustatory test） and brain MRI examination were performed on seven patients whose chief complaint were dysgeusia. Results Gustatory test （ sweet,salty,sour and bitter） showed gustatory anesthesia on one side in all patients. Lacuna infarctions in the ventralis medialis inferioe part of thalamus were detected by MRI in all these patients,among which the thalamus infarctions were on the opposite side of gustatory anesthesia in two cases,while on the same side in the other five ones. Conclusion To patients with only dysgeusia,gustatory test is important. The final diagnosis can be made through brain MRI. Gustatory pathway is characterized with homonymy ascending. The responsible focus for dysgeusia,parvicellular part of posteromedial ventral nucles （ VPMpc） in thalamus,can be demonstra-ted through coronal steric brain MRI. Dysgeusia caused by lacuna infarction of thalamus can be resumed.