Volume 15 Supplement 1
EHMTI-0139. Field-testing of the ICHD-3 beta diagnostic criteria for classical trigeminal neuralgia
© Maarbjerg et al; licensee Springer. 2014
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.
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.