Nasociliary neuralgia
| Classification according to ICD-10 | |
|---|---|
| G44.8 | Other specified headache syndromes |
| ICD-10 online (WHO version 2019) | |
The Nasoziliarisneuralgie (nasociliary neuralgia) belongs to the group of facial neuralgia . Some of their symptoms were described by Moritz Heinrich Romberg in 1840 , then again by Ulysse Trélat in 1882. It was not until the Chilean ophthalmologist Carlos Charlin fully described the disease in 1931. This is why nasociliary neuralgia was also called Charlin syndrome in the past.
Symptoms
In nasociliary neuralgia there is unilateral pain in the inner corner of the eye, which radiates into the eye socket and bridge of the nose. The pain is sharp. They last for seconds to hours and can occur while you are asleep. Concomitant symptoms on the affected side are lacrimation, swelling of the nasal mucosa, sweat secretion, reddening of the skin, conjunctivitis , keratitis , iritis and cyclitis . As a trigger ( trigger ) of the pain attacks touches are the ipsilateral , that same side nostril of the inner corner of the eye, bridge of the nose, the inferior turbinate known and chewing movements.
Anatomical basics
The nasociliary nerve arises from the first branch of the trigeminal nerve . Together with the oculomotor nerve and the trochlear nerve , it passes the tendinous annulus and runs along the inner edge of the orbital roof to the inner corner of the eye. It innervates the inner corner of the eye, the skin of the bridge of the nose and the mucous membrane of the turbinate, ethmoid cell and sphenoid sinus . In the cavernous sinus , a branch branches off to the ciliary ganglion .
etiology
The cause of nasociliary neuralgia is a neuritis of the nasociliary nerve or the ciliary ganglion as a result of inflammatory processes in the nasal, ethmoidal or sphenoid sinus area with unilateral rhinitis . Also, flu , diabetes , syphilis , tuberculosis and Karotisaneurysma are as etiologic described factors.
Differential diagnosis
In the differential diagnosis, cluster headache and sluder neuralgia must be distinguished. Soyka assumes that the nasociliary neuralgia, like the sluder neuralgia, are not to be assessed as independent clinical pictures. He regards both as variants of the cluster headache, a view that is shared by many authors today (see also the article on cluster headache). Nasociliary neuralgia can rarely be confused with trigeminal neuralgia , although the pain attacks of trigeminal neuralgia are usually shorter and the focus of pain perception is in the supply area of the lower two trigeminal branches.
therapy
In acute pain attacks, intranasal surface anesthesia with xylocaine or cocaine helps . Analogous to the therapy of cluster headache, oxygen inhalations, triptans and ergotamine are used today . Repeated blockages of the supraorbital , supratrochlear and infraorbital nerves caused by long-acting local anesthetics and systematic anesthetics of the mucous membranes can lead to permanent healing. Blockages of the superior cervical ganglion on the same side or repeated stellate blockages have also occasionally proven themselves. The last resort is to sever the nasociliary nerve. The calcium antagonists verapamil , prednisolone and lithium are used for interval therapy.
swell
- Dieter Soyka: Headache, Practical Neurology Volume 1 (Ed .: Bernhard Neundörfer, Dieter Soyka and Klaus Schimrigk), Edition Medicine of Verlag Chemie GmbH, Weinheim 1984, ISBN 3-527-15179-6 .
- Marco Mumenthaler : Neurology. Georg Thieme Verlag, 2002, ISBN 3-13-380010-8 .
- Werner Scheid: Textbook of Neurology. Georg Thieme Verlag, 1983, ISBN 3-13-394105-4 .
- Klaus Poeck, Werner Hacke: Neurology. Springer Verlag, Berlin 2006, ISBN 3-540-29997-1 .
- Peter Duus: Neurological-topical diagnostics. Georg Thieme Verlag, 2003, ISBN 3-13-535808-9 .
literature
- Hans-Christoph Diener (Ed.): Headache, Georg Thieme Verlag, 2003, ISBN 3-13-135671-5 .
