Maarbjerg Stine, Sørensen Morten Togo, Gozalov Aydin, Bendtsen Lars, Olesen Jes
Danish Headache Center, Department of Neurology, Glostrup Hospital.
Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
Cephalalgia. 2015 Apr;35(4):291-300. doi: 10.1177/0333102414542291. Epub 2014 Jul 22.
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.
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.
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).
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.
我们旨在对《国际头痛疾病分类》第三版（ICHD - 3β）中经典三叉神经痛（TN）的诊断标准进行现场测试。《国际疾病分类》第11版（ICD - 11β）的拟议β草案几乎完全基于ICHD - 3β的分类结构，尽管略有简化。我们比较了其与ICHD - 2标准的敏感性和特异性，并评估了修订的必要性。
在一项横断面研究设计中，系统地、前瞻性地收集了206例连续TN患者和37例连续持续性特发性面部疼痛患者的临床特征。
ICHD - 3β的特异性与ICHD - 2相似（97.3%对89.2%，p = 0.248），敏感性未变（76.2%对74.3%，p = 0.134）。TN患者中大多数假阴性诊断是由于临床检查时的感觉异常。采用ICHD - 3β的拟议修改版，可将敏感性提高到96.1%（与ICHD - 3β相比，p < 0.001），同时特异性维持在83.8%（与ICHD - 3β相比，p = 0.074）。
ICHD - 3β与ICHD - 2无显著差异，两者均缺乏敏感性。标准的修改极大地提高了敏感性，建议纳入即将发布的ICHD - 3中。
