Do individuals with Bell's palsy experience taste disturbances?

Taste Disturbances in Bell's Palsy

Yes, taste disturbances are a common feature of Bell's palsy, affecting the anterior two-thirds of the tongue due to involvement of the chorda tympani branch of the facial nerve. 1

Mechanism of Taste Disturbance

The facial nerve (CN VII) carries special sensory fibers responsible for taste sensation to the anterior two-thirds of the tongue through the chorda tympani branch. 2 When Bell's palsy causes inflammation and compression of the facial nerve within the narrow temporal bone canal, these taste fibers can be affected along with the motor fibers controlling facial muscles. 1

Clinical Presentation

• Taste disturbance or loss from the anterior tongue is an associated feature of Bell's palsy, occurring alongside the characteristic facial weakness. 1

• Additional features that may accompany Bell's palsy include hyperacusis (increased sensitivity to sound), dry eye, dry mouth, and sagging of the mouth corner due to involvement of other facial nerve branches. 1, 3

• The taste disturbance typically presents acutely along with the facial paralysis, developing within 72 hours of symptom onset. 4

Diagnostic Significance

• The presence of taste disturbance helps confirm the diagnosis of Bell's palsy as a peripheral facial nerve lesion rather than a central (stroke) cause, since central lesions typically spare taste function. 1

• Testing taste on the anterior two-thirds of the tongue during physical examination can be performed if equipment is available, though it is not mandatory for diagnosis. 4

Recovery Pattern

• Taste disturbances typically resolve along with the facial weakness during the recovery period. 4

• Most patients begin showing signs of recovery within 2-3 weeks, with complete recovery typically occurring within 3-4 months. 4

• Approximately 70-80% of patients recover completely, including resolution of taste disturbances. 5

Clinical Pitfall to Avoid

Do not dismiss taste complaints as unrelated to Bell's palsy—they are part of the expected clinical picture and help distinguish peripheral from central facial nerve lesions. 1