Abstract：
BACKGROUND: Trigeminal neuralgia (TN) is a chronic neuropathic pain disorder affecting one or more branches of the trigeminal nerve. Despite its relatively low global prevalence, TN is an important healthcare problem both in neurology departments and in emergency departments due to the difficulty of diagnosing and treating the condition and its significant impact on patients\' quality of life. For all these reasons, the Spanish Society of Neurology\'s Headache Study Group has developed a consensus statement on the management of TN.
METHODS: This document was drafted by a panel of neurologists specialising in headache, who used the terminology of the International Headache Society. We analysed the published scientific evidence on the diagnosis and treatment of TN and establish practical recommendations with levels of evidence.
CONCLUSIONS: The diagnosis of TN is based on clinical criteria. Pain attributed to a lesion or disease of the trigeminal nerve is divided into TN and painful trigeminal neuropathy, according to the International Classification of Headache Disorders, third edition. TN is further subclassified into classical, secondary, or idiopathic, according to aetiology. Brain MRI is recommended in patients with clinical diagnosis of TN, in order to rule out secondary causes. In MRI studies to detect neurovascular compression, FIESTA, DRIVE, or CISS sequences are recommended. Pharmacological treatment is the initial choice in all patients. In selected cases with drug-resistant pain or poor tolerance, surgery should be considered.
METHODS: This document was drafted by a panel of neurologists specialising in headache, who used the terminology of the International Headache Society. We analysed the published scientific evidence on the diagnosis and treatment of TN and establish practical recommendations with levels of evidence.
CONCLUSIONS: The diagnosis of TN is based on clinical criteria. Pain attributed to a lesion or disease of the trigeminal nerve is divided into TN and painful trigeminal neuropathy, according to the International Classification of Headache Disorders, third edition. TN is further subclassified into classical, secondary, or idiopathic, according to aetiology. Brain MRI is recommended in patients with clinical diagnosis of TN, in order to rule out secondary causes. In MRI studies to detect neurovascular compression, FIESTA, DRIVE, or CISS sequences are recommended. Pharmacological treatment is the initial choice in all patients. In selected cases with drug-resistant pain or poor tolerance, surgery should be considered.
摘要：
背景：三叉神经痛（TN）是一种慢性神经性疼痛障碍，影响三叉神经的一个或多个分支。尽管全球流行率相对较低，TN是神经内科和急诊科的重要医疗保健问题，因为该病的诊断和治疗困难，对患者的生活质量有重大影响。由于所有这些原因,西班牙神经病学会的头痛研究小组已经就TN的管理达成了共识。
方法：本文件由一组专门研究头痛的神经学家起草，他使用了国际头痛协会的术语。我们分析了已发表的关于TN诊断和治疗的科学证据，并建立了具有证据水平的实用建议。
结论：TN的诊断基于临床标准。由三叉神经病变或疾病引起的疼痛分为TN和疼痛性三叉神经病变，根据国际头痛疾病分类，第三版。TN进一步细分为经典，次要,或者特发性,根据病因。临床诊断为TN的患者建议行脑部MRI检查，以排除次要原因。在检测神经血管压迫的MRI研究中，FIESTA,驱动器,建议使用orCISS序列。药物治疗是所有患者的初始选择。在选定的耐药疼痛或耐受性较差的病例中，应该考虑手术。
方法：本文件由一组专门研究头痛的神经学家起草，他使用了国际头痛协会的术语。我们分析了已发表的关于TN诊断和治疗的科学证据，并建立了具有证据水平的实用建议。
结论：TN的诊断基于临床标准。由三叉神经病变或疾病引起的疼痛分为TN和疼痛性三叉神经病变，根据国际头痛疾病分类，第三版。TN进一步细分为经典，次要,或者特发性,根据病因。临床诊断为TN的患者建议行脑部MRI检查，以排除次要原因。在检测神经血管压迫的MRI研究中，FIESTA,驱动器,建议使用orCISS序列。药物治疗是所有患者的初始选择。在选定的耐药疼痛或耐受性较差的病例中，应该考虑手术。
