The Journal of Headache and Pain

Official Journal of the "European Headache Federation" and of "Lifting The Burden - The Global Campaign against Headache"

The Journal of Headache and Pain Cover Image

Volume 15 Supplement 1

Abstracts from the 4th European Headache and Migraine Trust International Congress: EHMTIC 2014

Open Access

EHMTI-0139. Field-testing of the ICHD-3 beta diagnostic criteria for classical trigeminal neuralgia

  • S Maarbjerg1,
  • MT Sørensen2,
  • A Gozalov1,
  • L Bendtsen1 and
  • J Olesen1
The Journal of Headache and Pain201415(Suppl 1):C38

Published: 18 September 2014


NeuropathyInternational ClassificationTrigeminal NeuralgiaModify VersionHeadache Disorder


In the summer of 2013 the International Headache Society (IHS) published the beta-version of the 3rd International Classification of Headache Disorders (ICHD-3 beta) with revised diagnostic criteria for classical trigeminal neuralgia (TN). The TN diagnostic criteria are based on expert opinion and IHS strongly encourages field-testing of the new diagnostic criteria.


We aimed to field-test ICHD-3 beta diagnostic criteria for TN by comparing sensitivity and specificity to ICHD-2 criteria, and evaluate needs for revision.


Clinical characteristics were systematically and prospectively collected from 206 consecutive TN patients and from 37 consecutive patients with persistent idiopathic facial pain in a cross-sectional study design. We used a modified version of the 2nd International Classification of Headache Disorders (ICHD-2) to allow for sensory abnormalities. Symptomatic trigeminal neuralgia and posttraumatic painful trigeminal neuropathy were excluded based on a thorough history and 3.0 Tesla MRI.


The specificity of ICHD-3 beta was similar to ICHD-2 (97.3% vs. 89.2%, p = 0.248) and the sensitivity was unchanged (76.2% vs. 74.3%, p = 0.134). The majority of false negative diagnoses in TN patients were due to sensory abnormalities. With a proposed modified version of ICHD-3 beta it was possible to increase sensitivity to 96.1% (p < 0.001 compared to ICHD-3 beta) while maintaining a specificity at 83.8% (p = 0.074 compared to ICHD-3 beta).


ICHD-3 beta was not significantly different from ICHD-2 and both lacked sensitivity. A modification of the criteria improved the sensitivity greatly and is proposed for inclusion in the forthcoming ICHD-3.

No conflict of interest.

Authors’ Affiliations

Danish Headache Center Department of Neurology, Glostrup Hospital University of Copenhagen, Glostrup, Denmark
Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark


© Maarbjerg et al; licensee Springer. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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