Nasociliary neuralgia (Charlin syndrome) | Inflammation of the facial nerves

Nasociliary neuralgia (Charlin syndrome)

The nasociliary nerve (“nasal lash nerve”) is a side branch of the ophtalmic nerve (1st main branch of the trigeminal nerve) and supplies the eye and nose with sensitive parts. If the inflammation of the nasociliary nerve causes neuralgia, unilateral pain in the corner of the eye occurs. Depending on their intensity, these may extend into the eye socket or into the bridge of the nose. In addition, there may be increased lacrimation and multiple inflammations of the eye, swelling of the nose or reddening of the skin. In nasociliary neuralgia, too, the trigger of the pain attacks is a slight stimulation of the nerve – either by touch or by movements when speaking or chewing.

Glossopharyngeal neuralgia

Inflammatory glossopharyngeal neuralgia is a rarely occurring pain pattern. Typical for neuralgia, very strong, stabbing pain attacks occur. The pain is mainly restricted to the hypopharynx, the lower throat. The back third of the tongue, the tonsils (tonsils) and sometimes also the ear hurt, triggered by movements such as speaking, chewing and swallowing or coughing. Since the glossopharyngeal nerve also affects the heart, the inflammation of it can lead to a slowed heart rate and, in the worst case, to cardiac arrest.

Auriculotemporalis neuralgia (Frey syndrome)

The nervus auriculotemporalis (“ear-sleep nerve”) is a lateral branch of the nervus mandibularis (3rd main branch of the trigeminal nerve).It guides the sensations of touch and pain of the ear, the auditory canal, the eardrum and the skin in the area of the temple. The nervus auriculotemporalis also connects to nerves that supply the parotid gland (parotis). If the nerve tissue is damaged by trauma, surgery or inflammation, or if the parotid gland has to be removed (resected), this can lead to auriculotemporal neuralgia.

You can find more information about this syndrome on our Frey Syndrome page. For example, various symptoms can occur after parotid gland surgery. At this point only the symptoms that affect the facial nerves are described.

Complications can include numbness and paralysis of the operated half of the face due to irritation or injury of the facial nerve. The symptoms can be temporary or long lasting. If the parotid gland has been completely removed, chewing sweating may result.

This means that the affected persons sweat in the cheek area after eating. It can also cause reddening of the skin, a feeling of swelling, tingling and burning pain in the cheek area. Through the injury of parasympathetic facial nerve fibers, these can come into contact with the sympathetic sweat glands of the cheek skin.

Both use the messenger substance acetylcholine, through which the cells communicate with each other. This can lead to the symptoms described above. This phenomenon is also known as Frey syndrome or auriculotemporal syndrome, Gustatory hyperhidrosis or Gustatory sweating.

To treat the relatively specific clinical picture of Frey syndrome, the patient is injected with botulinum toxin A, which paralyzes and thus inactivates the corresponding sweat glands. In addition, an operation in the area of the parotid gland can also lead to damage to facial nerve branches. This damage can result in restrictions of the mimic facial musculature. Often the corner of the mouth hanging down on one side is obvious. Depending on the damage to the branches, an inability to close the eyelid may also result.