CHARLINA SYNDROME

From Big Medical Encyclopedia

CHARLINA SINDROM (C. Char-lin, Chilean ophthalmologist, sort. in 1886, a synonym: neuralgia of a nosoresnichny nerve, a syndrome of a nasal nerve, a syndrome of a tsiliarny node, a nazo-etmoidalno-eye syndrome, Charlin's syndrome — Sladera) — the combined damage of a nosoresnichny nerve and a sympathetic resnrgchny node which is shown pristupakhm of pains and various vegetative disturbances in the respective areas of an innervation. Charlinom is described in 1931.

H page develops at damage of a nosoresnichny nerve (n. nasocili-aris) — one of branches of the optic nerve (item ophthalmicus) and a sympathetic ciliary node (gangl. ciliare) located in top of an eye-socket and tied with a perivascular sympathetic texture of an internal carotid artery (see the Autonomic nervous system), a third cranial nerve (see) and a trifacial (see).

In Ch.'s development by page inflammatory processes in paranasal sinuses (sinusitis), a hypertrophy of nasal sinks, a curvature of a nasal partition, a disease of dentoalveolar system, atherosclerosis of an internal carotid artery, vasculites (especially allergic) and others patol matter. processes, in to-rye the nosoresnichny nerve is involved, and it is frequent also a ciliary (tsiliarny) node.

Feature of a syndrome is emergence patol. the phenomena aged apprx. 40 years.

Clinically Ch. page is shown by attacks of painful pain in an eyeglobe, in a frontal bone and the corresponding half of a nose. Pains often arise at night and are followed by a photophobia (see), a hyperemia of a conjunctiva, plentiful dacryagogue, swelling of a mucous membrane of a nose and allocation of a liquid secret on the struck party. The painful attack can sometimes proceed days and more. Morbidity at a palpation in the field of an internal corner of an eye is noted. Quite often the herpetic keratitis, an iridocyclitis develops, an enanthesis of a nose, a forehead, a conjunctiva, a cornea appear (see Herpes). Perhaps bilateral manifestation of a syndrome.

Developed a wedge, the picture is noted seldom. The erased forms with less expressed a wedge, symptomatology are usually observed. Features a wedge, pictures are defined by dominance of symptoms of defeat of various branches of a nosoresnichny nerve — long ciliary nerves or a subblock nerve. At damage of long ciliary nerves pristupoobrazny pains of the pulling together character in an eyeglobe or in the depth of an eye-socket are characteristic. Pain arises in the evening or in the morning, proceeds for hours or days and is followed by a hyperemia of a conjunctiva of an eye, puffiness around eyes, a photophobia, dacryagogue, a frequent blinking, narrowing of a palpebral fissure, decrease or lack of corneal and conjunctival reflexes, disturbance of reaction of a pupil to light and local morbidity at a palpation. At dominance of damage of a subblock nerve generally expressed hyperemia of a conjunctiva and sharp morbidity at a palpation in the field of an internal corner of an eye is noted. When in patol. process is involved a ciliary node, the pain syndrome is combined with herpetic rashes. H page is characterized by a chronic current with long (2 — 3 years) remissions.

The diagnosis comes easy. Improvement or bystry regress of symptoms during the greasing of a mucous membrane of a nose on the party of defeat of 5% by solution of cocaine of a hydrochloride is a differential diagnostic character to Ch. to page and allows to carry out differential diagnosis with an epileptiform neuralgia (see), Slader's syndrome (see Slader a syndrome), acute glaucoma (see).

Treatment is directed to a basic disease, against the background of to-rogo the syndrome developed. At sinusitis carry out antiinflammatory therapy, at vascular pathology appoint vasodilating, hypotensive, anti-atherosclerotic means, polyvitamins; at a hypertrophy of nasal sinks and a curvature of a nasal partition an operative measure is shown.

At an attack apply mestnoanesteziruyushchy means, non-narcotic analgesics, vegetotrop-ny and vasodilators. At damage of long ciliary nerves it is recommended to dig in in a conjunctival sac of 1 — 2 drop 0,25% of solution of Dicainum with adrenaline (on 3 — 5 drops of 0,1% of solution of Adrenalinum hydrochloricum for 10 ml of solution of Dicainum). At defeat under - a block nerve — greasing of a mucous membrane of a nose in the place of an exit of a nerve over an upper nasal sink of 2% solution of cocaine of a hydrochloride with adrenaline (3 — 5 drops of 0,1% of solution of Adrenalinum hydrochloricum for 5 ml of solution of cocaine). In both cases duration of a course of treatment is 5 — 7 days. Diadynamic currents on area of a frontal bone are shown.

The forecast is defined by character of the basic patol. the process leading to Ch.'s development by page. In comparison with an epileptiform neuralgia at Ch. of page the forecast more favorable.

Prevention consists in the timely and systematic treatment of sinusitis, diseases of dentoalveolar system and other processes which are an origin of Ch. of page.

Bibliography:

Grechko V. E. Nieotlozh Nai help in neurostomatology, page 41, M., 1981; G. P Lip. Reference book

on a neurologic semiology, page 120, Kiev, 1983; With h and of 1 i n C. El sindrome del nervio nasal y sus formas larvadas, Dia med., v. 4, p. 35, 1931; it, Le syndrome du nerf nasal, Ann. Oculist. (Paris), t. 168, p. 86, 1931; Sluder G. Nasal neurology, headaches, and eye disorders, St Louis, 1927. Century of E. Grechko.

Яндекс.Метрика