Abstract
In the 3rd edition of the International Headache Classification, trigeminal neuralgia （13.1.1） is classified into three categories: classical trigeminal neuralgia （13.1.1.1）, secondary trigeminal neuralgia （13.1.1.2）, and idiopathic trigeminal neuralgia （13.1.1.3）. We aimed to clarify features of trigeminal neuralgia by investigating its clinical statistics. Clinical data of 105 patients with trigeminal neuralgia who visited the pain clinic of Nihon University Dental Hospital between November 2005 and December 2016 were analyzed retrospectively. Classical trigeminal neuralgia （13.1.1.1） was the most observed （n=97）, including 86 patients of classical trigeminal neuralgia with purely paroxysmal pain and 11 patients of classical trigeminal neuralgia with concomitant continuous pain. Seven patients with secondary trigeminal neuralgia （13.1.1.2）, attributed to space-occupying lesions, and one patient with idiopathic trigeminal neuralgia （13.1.1.3） were observed. Two of the seven cases originally had positive and/or negative signs of trigeminal nerve dysfunction, which subsequently changed to typical features with secondary trigeminal neuralgia （13.1.1.2）. Carbamazepine was effective against classical trigeminal neuralgia with purely paroxysmal pain; however, it showed low effectiveness against both classical trigeminal neuralgia with concomitant continuous pain and idiopathic trigeminal neuralgia. Based on the classification, stage, and progress of trigeminal neuralgia, it is necessary to choose an effective treatment such as medication therapy, microvascular decompression, or high-frequency thermal coagulation.
