Field-testing of the ICHD-3 beta diagnostic criteria for classical trigeminal neuralgia

Cephalalgia ◽  
2014 ◽  
Vol 35 (4) ◽  
pp. 291-300 ◽  
Author(s):  
Stine Maarbjerg ◽  
Morten Togo Sørensen ◽  
Aydin Gozalov ◽  
Lars Bendtsen ◽  
Jes Olesen
Keyword(s):  
Trigeminal Neuralgia ◽  
Diagnostic Criteria ◽  
False Negative ◽  
Field Testing ◽  
International Classification Of Diseases ◽  
Cross Sectional Study ◽  
International Classification ◽  
Cross Sectional ◽  
Classical Trigeminal Neuralgia

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.

Field-testing of the ICHD-3 beta/proposed ICD-11 diagnostic criteria for migraine with aura

Cephalalgia ◽  
2014 ◽  
Vol 35 (9) ◽  
pp. 748-756 ◽  
Author(s):  
Dana Li ◽  
Anne F Christensen ◽  
Jes Olesen
Keyword(s):  
Migraine With Aura ◽  
International Headache Society ◽  
Field Testing ◽  
International Classification Of Diseases ◽  
Familial Hemiplegic Migraine ◽  
Cross Sectional Study ◽  
International Classification ◽  
Hemiplegic Migraine ◽  
Cross Sectional

Introduction In 2013 the International Headache Society published the third International Classification of Headache Disorders beta-version, ICHD-3 beta. Its structure is identical to that of the present proposed version of the International Classification of Diseases (ICD-11), although slightly abbreviated to fulfill the needs of ICD-11. In the following, only ICHD-3 beta is mentioned, but findings regarding the validity of ICHD-3 beta categories are equally relevant to the forthcoming ICD-11. Here we field-tested the criteria for 1.2 migraine with aura (MA), 1.2.1 migraine with typical aura (MTA), 1.2.3 hemiplegic migraine, 1.2.2 migraine with brainstem aura, and the alternative criteria A1.2 MA and A1.2.1 MTA. Methods Clinical characteristics were systematically and prospectively collected from patients with 1.2.1 MTA, 1.2.4 familial hemiplegic migraine (FHM), 1.2.5 sporadic hemiplegic migraine (SHM) and 1.2.6 basilar-type migraine according to ICHD-2 in a cross-sectional study design. A database of 2464 patients with 1.1 migraine without aura and 1.2 migraine with non-hemiplegic aura and a database of 252 hemiplegic migraine patients (1.2.4 FHM or 1.2.5 SHM) was collected. We used SPSS 20 for Windows 8.0 for the statistical analysis. Results All ICHD-2 patients fulfilled ICHD-3 beta criteria for 1.2 MA. The ICHD-3 beta criteria for 1.2.1 MTA were more sensitive than ICHD-2 and ICHD-3 beta alternative criteria; they resulted in fewer probable MA diagnoses. Too many patients fulfilled ICHD-2 and ICHD-3 beta criteria for 1.2.2 migraine with brainstem aura. ICHD-3 beta criteria for 1.2.4 FHM and 1.2.5 SHM both comply with ICHD-2. Conclusion The new criteria in ICHD-3 beta/proposed ICD-11 for 1.2 MA, 1.2.1 MTA, 1.2.3.1 FHM and 1.2.3.2 SHM have more desirable properties than ICHD-2 and the ICHD-3 beta alternative criteria. The criteria for 1.2.2 migraine with brainstem aura should be more restrictive.

Trigeminal neuralgia (part I): Revisiting the clinical phenotype

Cephalalgia ◽  
2015 ◽  
Vol 36 (8) ◽  
pp. 730-746 ◽  
Author(s):  
Y Haviv ◽  
J Khan ◽  
A Zini ◽  
G Almoznino ◽  
Y Sharav ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Clinical Phenotype ◽  
Cross Sectional Study ◽  
Study Cohort ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Pain Attack ◽  
Classical Trigeminal Neuralgia ◽  
Background Pain

Aims We conducted a cross-sectional study to re-examine the clinical profile of patients with a clinical diagnosis of classical trigeminal neuralgia (CTN). Methods Inclusion criteria consisted of the International Headache Society’s published classification of CTN. For the specific purposes of the study, features such as autonomic signs, persistent background pain, attack durations of >2 minutes and reports of pain-related awakening were included. The demographic and clinical phenotype of each patient were carefully recorded for analysis. Results The study cohort consisted of 81 patients and based on reported attack duration these were divided into short (≤ 2 minutes, n = 61) and long (> 2 minutes, n = 20) groups for further analysis. The group with short attack duration neatly fit most of the criteria for CTN while the long attack group presents a more challenging diagnosis. There were no significant differences in pain severity, quality and location between the short and long attack groups. The frequency of persistent background pain was significantly higher in the long (70%) compared to the short attack group (29.5%, p = 0.001). There were significantly more reports of pain-related awakenings in the long (55%) than in the short attack groups (29.5%, p = 0.04). There were no significant differences in the frequency of autonomic signs between the short (21.3%) and long attack groups (40%, p = 0.1). In the short attack group, the presence of autonomic signs was significantly associated with longer disease duration, increased pain-related awakenings, and a reduced prognosis. Conclusion There are clear diagnostic criteria for CTN but often patients present with features, such as long pain attacks, that challenge such accepted criteria. In our cohort the clinical phenotype of trigeminal, neuralgiform pain with or without autonomic signs and background pain was observed across both short and long attack groups and the clinical implications of this are discussed.

International Classification of External Causes of Injury: a cross sectional study on its coverage rate in Iran

2019 ◽  
Author(s):  
Fatemeh Salehi ◽  
Leila Ahmadian ◽  
Shabnam Padidar
Keyword(s):  
Similar Rate ◽  
Cross Sectional Study ◽  
Coverage Rate ◽  
Classification Systems ◽  
International Classification ◽  
Cross Sectional ◽  
Car Accidents ◽  
External Causes ◽  
Car Accident

Abstract Background Injuries are a major health issue worldwide and their prevention requires access to accurate statistics in this area. This can be achieved by using the data collected through the international classification systems. This study aimed at investigating the coverage rate of the International Classification of External Causes of Injury (ICECI) regarding the external causes of injury in Shahid Bahonar Hospital.Method This cross-sectional descriptive-analytical study was performed on 322 injured individuals visiting the emergency unit of Shahid Bahonar Hospital. The data were gathered through patients’ records, a designed form and interviews. The collected data were encoded based on the ICECI textbook by two encoders. Their agreement rate was calculated using the Kappa estimate of agreement. The coverage rate of the classification system and the degree of completeness of the required data for encoding in the patients’ records was measured. Data were analyzed by the SPSS software, ver. 19.Results The findings showed that 70% of the studied external causes of injury were covered by the ICECI system. Among the 322 cases, 138 (43%) had been referred due to car accidents. The injured were mostly drivers of land transport vehicles who had been unintentionally involved in a car accident. The least mechanism for injury was bite injury with 5 (2%) cases which had occurred at home or public transport with a similar rate and totally unintentional. ICECI was capable of classifying 92% of the data related to incident causes. The most incongruous coverage of this system belonged to the "activity when injured" axis (n=18). Lack of precise data recording in the medical files resulted in missing data in at least one of the axis of the incident causes in most records.Conclusion Given that some information regarding the external cause of injury was not categorized by the ICECI system, this research can identify the shortcomings of the system and help its developers to amend it in future revisions.

scholarly journals Application of International Classification of Functioning, Disability and Health (ICF) in individuals with spinal cord injury

2011 ◽  
Vol 69 (3) ◽  
pp. 513-518 ◽  
Author(s):  
Janaina Vall ◽  
Carlos Mauricio de Castro Costa ◽  
Laura França Pereira ◽  
Tatiane Temmy Friesen
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cross Sectional Study ◽  
Social Attitudes ◽  
International Classification ◽  
International Classification Of Functioning ◽  
Cross Sectional ◽  
Cord Injury ◽  
The City

After spinal cord injury is common functionality is affected. OBJECTIVE: To evaluate the functionality of patients with spinal cord injury. METHOD: Cross-sectional study by means of the International Classification of Functionality (ICF). 109 adults with spinal cord injury in the city of Curitiba, Brazil were evaluated. RESULTS: The categories most compromised in body were intestines and bladder, sexuality, energy, sleep, emotion and weight. In the domain activities and participation, there was greater difficulty in tasks of bathing, toilet and dressing, self care and leisure. In the domain environmental factors, the categories classified as facilitators were: medications, orthoses and wheelchair, attitude of family, transport, social foresight and health services. The categories classified as barriers were: attitude of authorities, social attitudes, education and work. CONCLUSION: The application of the ICF in persons with spinal cord injury demonstrated a series of disabilities and limitations.

scholarly journals Field-testing the new anaphylaxis' classification for the WHO International Classification of Diseases-11 revision

Allergy ◽  
2017 ◽  
Vol 72 (5) ◽  
pp. 820-826 ◽  
Author(s):  
L. K. Tanno ◽  
N. Molinari ◽  
S. Bruel ◽  
J.-L. Bourrain ◽  
M. A. Calderon ◽  
...  
Keyword(s):  
Field Testing ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Classification Of Diseases

Association between neurovascular contact and clinical characteristics in classical trigeminal neuralgia: A prospective clinical study using 3.0 Tesla MRI

Cephalalgia ◽  
2015 ◽  
Vol 35 (12) ◽  
pp. 1077-1084 ◽  
Author(s):  
Stine Maarbjerg ◽  
Frauke Wolfram ◽  
Aydin Gozalov ◽  
Jes Olesen ◽  
Lars Bendtsen
Keyword(s):  
Trigeminal Neuralgia ◽  
Clinical Characteristics ◽  
Cross Sectional Study ◽  
Prospective Clinical Study ◽  
Structured Interviews ◽  
3.0 Tesla ◽  
Cross Sectional ◽  
Classical Trigeminal Neuralgia ◽  
Duration Of Disease ◽  
Symptomatic Side

Background Previous studies demonstrated that a severe neurovascular contact (NVC) causing displacement or atrophy of the trigeminal nerve is highly associated with classical trigeminal neuralgia (TN). There are no studies describing the association between the clinical characteristics of TN and severe NVC. Methods Clinical characteristics were prospectively collected from consecutive TN patients using semi-structured interviews in a cross-sectional study design. We evaluated 3.0 Tesla MRI blinded to the symptomatic side. Results We included 135 TN patients. Severe NVC was more prevalent in men (75%) compared to women (38%) ( p < 0.001), and the odds in favor of severe NVC on the symptomatic side were 5.1 times higher in men compared to women (95% CI 2.3–10.9, p < 0.001). There was no difference between patients with and without severe NVC in age (≥60 years vs. <60) (OR 1.6 95% CI (0.8–3.4), p = 0.199) or duration of disease ( p = 0.101). Conclusions Severe NVC was much more prevalent in men than in women, who may more often have other disease etiologies causing or contributing to TN. Severe NVC was not associated with age or with duration of disease.

Tolosa-Hunt Syndrome: Appraising the ICHD-3 beta diagnostic criteria

Cephalalgia ◽  
2017 ◽  
Vol 38 (10) ◽  
pp. 1696-1700 ◽  
Author(s):  
Evan Mullen ◽  
Mark Green ◽  
Eliza Hersh ◽  
Alfred-Marc Iloreta ◽  
Joshua Bederson ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
False Negative ◽  
Granulomatous Inflammation ◽  
International Classification ◽  
Headache Disorders ◽  
Hunt Syndrome ◽  
Cranial Nerve Palsies ◽  
Beta Version

Introduction The term Tolosa-Hunt Syndrome was first used more than half a century ago to describe painful ophthalmoplegia accompanied by cranial nerve palsies. In the decades since, its diagnostic criteria have evolved considerably. The beta version of the 3rd Edition of the International Classification of Headache Disorders narrows these criteria to require the demonstration of granulomatous inflammation on MRI or biopsy. We believe this may introduce challenges to accurate diagnosis. Discussion Requiring the demonstration of granulomatous inflammation for a diagnosis of Tolosa-Hunt Syndrome may introduce the potential for false negative and false positive diagnoses. Although the disorder presents secondary to granulomatous inflammation, MRI technology may not be able to identify it reliably, and biopsy is not always indicated for its symptomatology. Additionally, several cases have been reported of Tolosa-Hunt Syndrome diagnosed with MRI-confirmed granulomatous inflammation that later prove to be attributable to other pathologies. The emphasis on neuroimaging may therefore exclude some true Tolosa-Hunt Syndrome cases and include others resulting from other latent pathologies that are not visible on MRI. Conclusion We wish to offer several potential modifications to the International Classification of Headache Disorders guidelines for Tolosa-Hunt Syndrome, including making the demonstration of granulomatous inflammation on MRI or biopsy non-mandatory and lengthening patient follow-up to two years for cases in which MRI is unrevealing.

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