Facial pain and the second edition of the International Classification of Headache Disorders.

BACKGROUND

Recurrent or chronic facial pain may be a diagnostic challenge. Applying the diagnostic criteria of the second edition of the International Classification of Headache Disorders (ICHD-II) leaves a considerable number of patients unclassifiable.

OBJECTIVE

The aim of this study was to establish and evaluate revised criteria of trigeminal neuralgia and persistent idiopathic facial pain.

METHODS

Based on the diagnostic value of 12 clinical features of trigeminal neuralgia and 15 features of persistent idiopathic facial in 97 patients referred for facial pain to a neurological tertiary care centre we established revised criteria for persistent idiopathic facial pain and additional criteria for probable trigeminal neuralgia and probable idiopathic facial pain.

RESULTS

Applying the newly proposed criteria reduced the number of patients with facial pain not classifiable by more than 50%. The new criteria improved the sensitivity, particularly in idiopathic facial pain and did not cause a relevant decrease in specificity compared to ICHD-II.

CONCLUSION

This study suggests that amendments to the ICHD-II criteria improve the diagnostic classification of facial pain.