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


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
Faculty of Health and Medical Sciences, University of Copenhagen


© 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 (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.