Trigeminal neuralgia laboratory findings

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Diagnostic Criteria

 The International Classification of Headache Disorders, Third Edition (ICHD-3) diagnostic criteria for TN are as follows:

• A) Recurrent paroxysms of unilateral facial pain in the distribution(s) of one or more divisions of the trigeminal nerve, with no radiation beyond, and fulfilling criteria B and C

• B) Pain has all of the following characteristics:

Lasting from a fraction of a second to two minutes

Severe intensity

Electric shock-like, shooting, stabbing or sharp in quality

• C) Precipitated by innocuous stimuli within the affected trigeminal distribution

• D) Not better accounted for by another ICHD-3 diagnosis

The ICHD-3 further defines several subtypes of TN :

1. Classic (or classical) TN, which develops without apparent cause other than neurovascular compression, fulfilling the criteria above and requiring demonstration on MRI or during surgery of neurovascular compression (not simply contact), with morphological changes in the trigeminal nerve root. Most patients with classic TN will have a purely paroxysmal form without persistent background facial pain (ie, they are pain-free between attacks in the affected trigeminal distribution). Occasional patients who fulfill criteria for classic TN may have continuous or near-continuous facial pain of moderate intensity in the affected area, thereby meeting ICHD-3 criteria for classic TN with concomitant continuous facial pain, also known as atypical TN or TN type
2. Secondary TN, defined as TN caused by an underlying disease. Recognized causes include multiple sclerosis, cerebellopontine angle tumor, and arteriovenous malformation.
3. Idiopathic TN, defined as TN with neither electrophysiological tests nor MRI showing significant abnormalities.