Charlin Syndrome





Key Words

Charlin’s syndrome, Charlin-Sluder syndrome, eye pain, facial pain, headache, nasociliary ganglion, nasociliary nerve block cluster headache, nasociliary neuralgia

 





ICD-10 CODE G50.0





Clinical Syndrome


Charlin syndrome, also known as nasociliary neuralgia and Charlin-Sluder cephalgia, is an uncommon cause of head and face pain. As with most headache syndromes, the exact cause of the pain of Charlin syndrome is unknown. However, the pathogenesis of this uncommon cause of head and face pain is thought to be dysfunction of the nasociliary ganglion in a manner analogous to the dysfunction of the sphenopalatine ganglion thought to be the source of cluster headache. The pain of Charlin syndrome has a rapid onset to peak, with attacks lasting 45 to 60 minutes. In some patients, these attacks can be triggered by sensory stimulation of the affected areas. Although in many ways similar to cluster headache (e.g., retroorbital location of pain, profuse unilateral rhinorrhea, rapid onset to peak, and short duration of attacks), many dissimilarities also exist. In contrast to cluster headache, alcohol consumption does not appear to trigger attacks of Charlin syndrome and the seasonal and chronobiological patterns so characteristic of cluster headache do not seem to be a factor ( Table 5.1 ). Blockade of the sphenopalatine ganglion, which is so effective in the treatment of cluster headache, is of little value in the treatment of Charlin syndrome. Patients suffering from Charlin syndrome uniformly respond to daily nasociliary nerve blocks with local anesthetic, as described subsequently.



Table 5.1

Comparison of Cluster Headache and Charlin Syndrome




































































Comparison Factors Cluster Headache Charlin Syndrome
Ocular and retroorbital location Yes Yes
Unilateral Yes Yes
Rapid onset to peak Yes Yes
Severe intensity Yes Yes
Attacks occur in paroxysms Yes Yes
Duration of attacks short Yes Yes
Pain free between attacks Yes Yes
Significant rhinorrhea during attacks Yes Yes
Alcohol triggers attacks Yes No
Tactile trigger areas No Yes
Seasonal pattern of attacks Yes No
Chronobiological pattern of attacks Yes No
Significant eye inflammation No Yes
Responds to sphenopalatine ganglion block Yes No
Responds to nasociliary block No Yes

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Feb 9, 2020 | Posted by in PAIN MEDICINE | Comments Off on Charlin Syndrome

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