Abstract
In the international classification of headache disorders, 3rd edition （ICHD-3β）, trigeminal neuralgia （13.1） is classified into two categories: classical trigeminal neuralgia （13.1.1） and painful trigeminal neuropathy （13.1.2） （previously referred to as symptomatic trigeminal neuralgia）. We aimed to clarify the features of trigeminal neuralgias by investigating clinical statistics of patients with trigeminal neuralgia. The clinical data of 48 patients with trigeminal neuralgia who visited the headache and orofacial pain clinic and oral medicine department at Tokyo Dental College Ichikawa General Hospital between July 2017 and December 2019 were analyzed retrospectively. The patients comprised 11 men and 37 women with the average age of 60.0±13.8 years. Classical trigeminal neuralgia （13.1.1） was most commonly observed （n＝46）. Painful trigeminal neuropathy attributed to a space-occupying lesion （13.1.2.5）, a subclass of a painful trigeminal neuropathy, was observed in two patients. One of them had several characteristics, such as normal neurologic findings and effectiveness of carbamazepine, indicating that it is difficult to distinguish between classical trigeminal neuralgia and painful trigeminal neuropathy attributed to a space-occupying lesion. Even if patients have features of typical trigeminal neuralgia, a certain proportion of them have a brain tumor. Hence, a physical exam with particular attention to neurologic function screening, and MRI are useful to detect occult intracranial lesions.
