A New Clinical Classification of Trigeminal Neuralgia

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Trigeminal neuralgia is a nonrare medical entity, but always a clinical syndrome characterized by a facial brief and repetitive electric shock pain with a ratio of female to male as 2:1 of long evolution and progressive with the highest prevalence in the adult population. In its early years, the patient can control the pain with pharmacological treatment, over time the intensity, extent and is often progressive and disabling with lack of therapeutic response or adverse effects; there is no staging of the natural history of the disease in its typical compressive form. In the past 12 years, 336 patients charts with trigeminal pain were analyzed, 146 cases were treated by using any neurosurgical procedure with a long time successful rate of 96%. On the basis of this data, information propose a new clinical classification for identifying the disease in three phases, an initial pharmacological “honeymoon” phase 53% of our cases, the intermediate one when the patients search any alternative or palliative therapy were treated 22%, and the advanced phase when the patients become susceptible to surgical treatment that eradicates the compressive cause 25%. We also have detected in the advanced stage as three subgroups based on their chronicity, complexity, or complicated. Also, should be considered atypical variant and others craniofacial pain syndromes as a contributory factor.