Charlin's syndrome is a rare neuralgia along the external nasal nerve.
Anatomy:
(1) Sensory nerves to the nose arise from the ophthalmic and maxillary divisions of the trigeminal nerve CN V.
(2) The nasociliary nerve is a branch of the ophthalmic division, which gives rise to the anterior ethmoidal nerve. This gives rise to the external and external nasal nerves.
Causes:
(1) trauma
(2) rhinoplasty or other surgery
(3) idiopathic
Clinical features:
(1) atypical facial pain, which primarily involves the external nose. Pain be continuous or episodic. It may range from mild to severe. There may be a trigger point on the nose.
(2) variable ocular and retro-orbital pain
(3) variable headache, often involving the forehead
(4) variable unilateral rhinorrhea
(5) variable conjunctival injection
(6) negative work-up for other causes of facial pain (sinusitis, other)
Management:
(1) local anesthesia to external nasal nerve
(2) sphenopalatine ganglion block
(3) radiofrequency ablation
