title: Field-testing of the ICHD-3 beta diagnostic criteria for classical trigeminal neuralgia.
abstract: BACKGROUND
  We aimed to field-test the beta version of the third edition of the International Classification of Headache Disorders (ICHD-3 beta) diagnostic criteria for classical trigeminal neuralgia (TN). The proposed beta draft of the 11th version of the International Classification of Diseases (ICD-11 beta) is almost exclusively based on the ICHD-3 beta classification structure although slightly abbreviated. We compared sensitivity and specificity to ICHD-2 criteria, and evaluated the needs for revision.
  
  
  METHODS
  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.
  
  
  RESULTS
  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 at clinical examination. 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 specificity at 83.8% (p = 0.074 compared to ICHD-3 beta).
  
  
  CONCLUSIONS
  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.
authors: Danish Headache Center, Department of Neurology, Glostrup Hospital.
authors: Stine
authors: S
authors: Maarbjerg
authors: Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
authors: Morten Togo
authors: MT
authors: Sørensen
authors: Danish Headache Center, Department of Neurology, Glostrup Hospital.
authors: Aydin
authors: A
authors: Gozalov
authors: Danish Headache Center, Department of Neurology, Glostrup Hospital.
authors: Lars
authors: L
authors: Bendtsen
authors: Danish Headache Center, Department of Neurology, Glostrup Hospital jes.olesen@regionh.dk.
authors: Jes
authors: J
authors: Olesen
mesh_terms: D005260:Female; D006801:Humans; D038801:International Classification of Diseases / Q000592:standards*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014277:Trigeminal Neuralgia / Q000145:classification* / Q000175:diagnosis*
keywords: Trigeminal neuralgia; clinical characteristics; concomitant persistent pain; diagnostic criteria; field-testing; persistent idiopathic facial pain; sensitivity and specificity; sensory abnormalities