Gustatory pain: a complication of carotid endarterectomy.

A unique pain syndrome, triggered by gustatory stimuli in the absence of anatomic obstruction of the parotid duct, complicated carotid endarterectomy. We documented asymmetric parotid vasodilatation and sympathetic dysfunction in cutaneous areas overlaying the gland. We postulate that damage to the sympathetic innervation of the parotid gland resulted in unopposed parasympathetically mediated glandular vasodilatation. Vasoactive intestinal polypeptide may have played a role in producing symptoms. A similar syndrome occurs in patients with acute pandysautonomia.