Gustatory rhinitis in multiple system atrophy

Abstract

Gustatory rhinitis is a type of nonallergic, noninflammatory rhinitis. A high incidence of rhinorrhea, including gustatory rhinitis, is reported in patients with Parkinson's disease (PD). Herein, we report a case of gustatory rhinitis in a patient with a parkinsonian variant of multiple system atrophy (MSA-P). A 56-year-old man presented with gustatory rhinorrhea and bilateral copious nasal discharge while eating. Three years before visiting the ear, nose, and throat clinic, he developed Parkinsonism and was suspected of having MSA-P. He underwent posterior nasal neurectomy under endoscopic guidance, but it did not significantly reduce the rhinorrhea during eating. Pathological examination of the mucosa of the inferior turbinate demonstrated minimal inflammatory cellular infiltration. Severe (gustatory) rhinitis may also be a useful biomarker for the diagnosis of synucleinopathies, including PD and MSA, akin to anosmia, which is a wellknown biomarker for the early diagnosis of PD.

Old man’s drip: What’s new

“…Severe gustatory rhinitis may be considered a useful biomarker for the diagnosis of synucleinopathy. 4 In the absence of any confirmatory objective tests, stimulation of the tongue tip with drops of lemon juice and observing for rhinorrhoea may help with diagnosis. 5 Management strategies for this condition might align with those used for gustatory rhinitis, focusing on identifying triggers and employing avoidance techniques or symptomalleviating measures as appropriate.…”