TABLE 1.
Comparison: Burchiel's classification and the classification of the International Headache Society (IHS)
| Burchiel's classification | History/pattern | Causes | IHS classification | Causes |
|---|---|---|---|---|
| Spontaneous onset | Trigeminal neuralgia | |||
| TN type I | >50% paroxysmal pain | Neurovascular compression of trigeminal nerve or unknown | Classical trigeminal neuralgia, purely paroxysmal | Neurovascular compression exclusively |
| TN type II | <50% paroxysmal pain | Neurovascular compression of trigeminal nerve or unknown | Classical trigeminal neuralgia with concomitant continuous pain | Classical trigeminal neuralgia with persistent background facial pain |
| Symptomatic TN | TN due to multiple sclerosis, tumors, etc. | Demyelination | Secondary trigeminal neuralgia | Due to multiple sclerosis, tumor, AV‐malformation, etc. |
| Idiopathic trigeminal neuralgia | Trigeminal neuralgia with neither electrophysiological tests nor MRI abnormalities | |||
| Atypical facial pain | Painful trigeminal neuropathy | |||
|
Peripheral trigeminal injury TNP |
Incidental nonintentional injury | ENT/oral surgery, facial trauma, stroke, etc. | Painful post‐traumatic trigeminal neuropathy | Mechanical, chemical, thermal, or caused by radiation. Post neuroablative procedures for trigeminal neuralgia |
| Trigeminal deafferentation pain | Trigeminal injury from peripheral ablation |
RF rhizotomy, glycerol rhizolysis, GKR balloon compression, etc. |
||
| PTN attributed to other disorders | Secondary to multiple sclerosis, space‐occupying lesion or systemic disease, with only the clinical characteristics (quality of spontaneous pain, evoked pain and presence of sensory deficits) | |||
| Postinfection | ||||
| Postherpetic neuralgia | Herpes zoster outbreak | Shingles involving trigeminal distribution | PTN attributed to herpes zoster | Unilateral facial pain of less than 3 months’ duration caused by and associated with other symptoms and/or clinical signs of acute herpes zoster |
| Trigeminal post‐herpetic neuralgia | Unilateral facial pain persisting or recurring for at least 3 months | |||
| Idiopathic PTN | Unknown etiology with clinically evident positive (hyperalgesia, allodynia) and/or negative (hypaesthesia, hypalgesia) signs of trigeminal nerve dysfunction |
Abbreviations: ENT, ear, nose and throat; GKR, gamma‐knife radio surgery; RF, radio frequency; TN, trigeminal neuralgia; TNP, trigeminal neuropathic pain.