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  • Title: Field-testing of the ICHD-3 beta diagnostic criteria for classical trigeminal neuralgia.
    Author: Maarbjerg S, Sørensen MT, Gozalov A, Bendtsen L, Olesen J.
    Journal: Cephalalgia; 2015 Apr; 35(4):291-300. PubMed ID: 25053751.
    Abstract:
    INTRODUCTION: 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). CONCLUSION: 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.
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