Ageusia, hyposmia, dizziness and tinnitus as presenting symptoms of multiple sclerosis

Multiple Sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system characterized by the destruction of myelin sheaths and axonal loss. Presenting symptoms of multiple sclerosis may vary and if not promptly identified may lead to a delayed diagnosis of Multiple sclerosis. In this paper, we present a rare case of a patient with ageusia as presenting symptom of Multiple sclerosis; the symptom spontaneously resolved after two weeks and was followed by hyposmia, dizziness, tinnitus and facial paraesthesia that eventually led to a clinical diagnosis of Multiple sclerosis. The presence of gustatory, olfactory and audio-vestibular symptoms has been associated with disease activity and progression of several inflammatory and neurodegenerative diseases of the central nervous system including Multiple sclerosis. Gustatory alterations may be due to the presence of demyelinating lesion in the brain area of taste; the progression of the disease may explain the additional olfactory and audio-vestibular symptoms described in this patient. Even if taste alteration is an extremely rare presenting symptom of Multiple sclerosis, its presence in young women should always be carefully investigated as it could be an early sign of Multiple sclerosis.