{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T23:36:47Z","timestamp":1776296207236,"version":"3.50.1"},"reference-count":29,"publisher":"Walter de Gruyter GmbH","issue":"4","license":[{"start":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T00:00:00Z","timestamp":1627862400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_sjpain-2021-0045_s_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Patients with facial pain are sometimes referred for neurosurgical treatment with a poorly documented diagnosis of trigeminal neuralgia. In such cases, neurosurgery will usually not be helpful. We conducted a re-evaluation of the diagnosis in patients referred for neurosurgical treatment of presumed trigeminal neuralgia. Our objective was to find out why and how often misdiagnosis occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2021-0045_s_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was done in consecutive first-time patients referred for trigeminal neuralgia to our outpatient clinic in 2019. We used five ICHD-3-based clinical criteria to verify or exclude the diagnosis. In patients where trigeminal neuralgia was excluded, we established a diagnosis for their facial pain based upon medical history and a physical examination by a neurosurgeon\u00a0\u2013 often supplemented with examination by an oral surgeon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2021-0045_s_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty-eight patients were referred for presumed trigeminal neuralgia. Only 17 of them fulfilled the five criteria and were diagnosed with trigeminal neuralgia. In\u00a020 of the remaining 21 patients trigeminal neuralgia could be clearly excluded, while one of the patients had a periodontitis closely mimicking trigeminal neuralgia. In 14\u00a0of the 21 patients we diagnosed temporomandibular dysfunction or dental conditions. MRI scans had detected low-grade neurovascular contacts in 13 of the 21 patients, a finding that was clearly overestimated by the referring neurologists in seven patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2021-0045_s_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Overdiagnosis of trigeminal neuralgia was common in patients referred for neurosurgery, mostly due to insufficient clinical evaluation combined with an overestimation of MRI-detected NVCs. The clinical diagnosis should be critically re-evaluated before recommending neurosurgery to patients referred for presumed trigeminal neuralgia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/sjpain-2021-0045","type":"journal-article","created":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T16:27:13Z","timestamp":1627835233000},"page":"788-793","source":"Crossref","is-referenced-by-count":11,"title":["Is this really trigeminal neuralgia? Diagnostic re-evaluation of patients referred for neurosurgery"],"prefix":"10.1515","volume":"21","author":[{"given":"Haldor","family":"Sletteb\u00f8","sequence":"first","affiliation":[{"name":"Department of Neurosurgery , Rikshospitalet, Oslo University Hospital , Pb 4950 Nydalen , 0424 Oslo , Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2021,8,2]]},"reference":[{"key":"2025120910043525209_j_sjpain-2021-0045_ref_001","unstructured":"White, JC, Sweet, WH. Pain\u00a0\u2013 its mechanism and neurosurgical control. Springfield, Illinois: Charles C. Thomas Publisher; 1955:433\u20134 pp."},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_002","doi-asserted-by":"crossref","unstructured":"Maarbjerg, S, Di Stefano, G, Bendtsen, L, Cruccu, G. Trigeminal neuralgia\u00a0\u2013 diagnosis and treatment. Cephalalgia 2017;37:648\u201357. https:\/\/doi.org\/10.1177\/0333102416687280.","DOI":"10.1177\/0333102416687280"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_003","doi-asserted-by":"crossref","unstructured":"International Headache Society. Headache classification committee of the international headache society (IHS). Int Classif Headache Disord 3rd edition Cephalalgia 2018;38:1\u2013211. https:\/\/doi.org\/10.1177\/0333102417738202.","DOI":"10.1177\/0333102417738202"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_004","doi-asserted-by":"crossref","unstructured":"Bendtsen, L, Zakrzewska, JM, Abbott, J, Braschinsky, M, Di Stefano, G, Donnet, A, et al.. European Academy of Neurology guideline on trigeminal neuralgia. Eur J Neurol 2019;0:1\u201319. https:\/\/doi.org\/10.1111\/ene.13950.","DOI":"10.1111\/ene.13950"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_005","doi-asserted-by":"crossref","unstructured":"Bendtsen, L, Zakrzewska, JM, Heinskou, TB, Hodaie, M, Leal, PRL, Numikko, T, et al.. Advances in diagnosis, classification, pathophysiology, and management of trigeminal neuralgia. Lancet Neurol 2020;19:784\u201396. https:\/\/doi.org\/10.1016\/S1474-4422(20)30233-7.","DOI":"10.1016\/S1474-4422(20)30233-7"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_006","doi-asserted-by":"crossref","unstructured":"Sjaastad, O, Bakketeig, LS. The rare, unilateral headaches. Vaga study of headache epidemiology. J Headache Pain 2007;8:19\u201327. https:\/\/doi.org\/10.1007\/s10194-006-0292-4.","DOI":"10.1007\/s10194-006-0292-4"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_007","doi-asserted-by":"crossref","unstructured":"Mueller, D, Obermann, M, Yoon, M-S, Poitz, F, Hansen, N, Slomke, M-A, et al.. Prevalence of trigeminal neuralgia and persistent idiopathic facial pain: a population-based study. Cephalalgia 2011;31:1542\u20138. https:\/\/doi.org\/10.1177\/0333102411424619.","DOI":"10.1177\/0333102411424619"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_008","doi-asserted-by":"crossref","unstructured":"Haviv, Y, Khan, J, Zini, A, Almoznino, G, Sharav, Y, Benoliel, R. Trigeminal neuralgia (part I): revisiting the clinical phenotype. Cephalalgia 2016;36:730\u201346. https:\/\/doi.org\/10.1177\/0333102415611405.","DOI":"10.1177\/0333102415611405"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_009","doi-asserted-by":"crossref","unstructured":"Donnet, A, Simon, E, Cuny, E, Demarquay, G, Ducros, A, De Galon, S, et al.. Recommandations pour le diagnostic et la prise en charge de la n\u00e9vralgie trig\u00e9minale classique. Neurochirurgie 2018;64:285\u2013302. https:\/\/doi.org\/10.1016\/j.neuchi.","DOI":"10.1016\/j.neuchi.2018.04.001"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_010","doi-asserted-by":"crossref","unstructured":"Di Stefano, G, Maarbjerg, S, Nurmikko, T, Truini, A, Cruccu, G. Triggering trigeminal neuralgia. Cephalalgia 2018;38:1049\u201356. https:\/\/doi.org\/10.1177\/0333102417721677.","DOI":"10.1177\/0333102417721677"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_011","doi-asserted-by":"crossref","unstructured":"Cruccu, G, Di Stefano, G, Truini, A. Trigeminal neuralgia. N Engl J Med 2020;383:754\u201362. https:\/\/doi.org\/10.1056\/NEJMra1914484.","DOI":"10.1056\/NEJMra1914484"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_012","doi-asserted-by":"crossref","unstructured":"Maarbjerg, S, Gozalov, A, Olesen, J, Bendtsen, L. Concomitant persistent pain in classical trigeminal neuralgia\u00a0\u2013 evidence for different subtypes. Headache 2014;54:1173\u201383. https:\/\/doi.org\/10.1111\/head.12384.","DOI":"10.1111\/head.12384"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_013","doi-asserted-by":"crossref","unstructured":"Maarbjerg, S, Wolfram, F, Heinskou, TB, Rochat, P, Gozalov, A, Brennum, J, et al.. Persistent idiopathic facial pain - a prospective systematic study of clinical characteristics and neuroanatomical findings at 3.0 Tesla MRI. Cephalalgia 2017;37:1231\u201340. https:\/\/doi.org\/10.1177\/0333102416675618.2017.","DOI":"10.1177\/0333102416675618"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_014","doi-asserted-by":"crossref","unstructured":"Casey, KF. Role of patient history and physical examination in the diagnosis of trigeminal neuralgia. Neurosurg Focus 2005;18:E1. https:\/\/doi.org\/10.3171\/foc.2005.18.5.2.","DOI":"10.3171\/foc.2005.18.5.2"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_015","doi-asserted-by":"crossref","unstructured":"Cruccu, G, Finnerup, N, Jensen, TS, Scholz, J, Sindou, M, Svensson, P, et al.. Trigeminal neuralgia: new classification and diagnostic grading for practice and research. Neurology 2016;87:220\u20138. https:\/\/doi.org\/10.1212\/WNL.0000000000002840.","DOI":"10.1212\/WNL.0000000000002840"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_016","doi-asserted-by":"crossref","unstructured":"Melis, M, Lobo, SL, Ceneviz, C, Zawawi, K, Al-Badawi, E, Maloney, G, et al.. Atypical odontalgia: a review of the literature. Headache 2003;43:1060\u201374. https:\/\/doi.org\/10.1046\/j.1526-4610.2003.03207.x.","DOI":"10.1046\/j.1526-4610.2003.03207.x"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_017","doi-asserted-by":"crossref","unstructured":"Renton, T. Persistent pain after dental surgery. Rev Pain 2011;5:8\u201317. https:\/\/doi.org\/10.1177\/204946371100500103.","DOI":"10.1177\/204946371100500103"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_018","doi-asserted-by":"crossref","unstructured":"Gerwin, R. Chronic facial pain: trigeminal neuralgia, persistent idiopathic facial pain, and myofascial pain syndrome\u00a0\u2013 an evidence-based narrative review and etiological hypothesis. Int J Environ Res Publ Health 2020;17:7012. https:\/\/doi.org\/10.3390\/ijerph17197012.","DOI":"10.3390\/ijerph17197012"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_019","doi-asserted-by":"crossref","unstructured":"Dzhafarov, V, Rzaev, J, Moysak, G, Voronina, E. Case report: facial pain as an initial manifestation of intramedullary cervical spinal cord tumor: a case report and literature review. Surg Neurol Int 2020;11:173. https:\/\/doi.org\/10.25259\/SNI_546_2019.","DOI":"10.25259\/SNI_546_2019"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_020","unstructured":"Zakrzewska, JM, Padfield, D. The patient\u2019s journey through trigeminal neuralgia. Pain Clin Updates 2014;XXII:1\u20138."},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_021","doi-asserted-by":"crossref","unstructured":"von Eckardtstein, KL, Keil, M, Rohde, V. Unnecessary dental procedures as a consequence of trigeminal neuralgia. Neurosurg Rev 2015;38:355\u201360. discussion 360. https:\/\/doi.org\/10.1007\/s10143-014-0591-1.","DOI":"10.1007\/s10143-014-0591-1"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_022","doi-asserted-by":"crossref","unstructured":"Tripathi, M, Sadashiva, A, Gupta, A, Jani, P, Pulickal, SJ, Deora, H, et al.. Please spare my teeth! Dental procedures and trigeminal neuralgia. Surg Neurol Int 2020;11:455. https:\/\/doi.org\/10.25259\/SNI_729_2020.","DOI":"10.25259\/SNI_729_2020"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_023","doi-asserted-by":"crossref","unstructured":"Antonaci, F, Arceri, S, Rakusa, M, Mitsikostas, DD, Milanov, I, Todorov, V, et al.. Pitfalls in recognition and management of trigeminal neuralgia. J Headache Pain 2020;21:82. https:\/\/doi.org\/10.1186\/s10194-020-01149-8.","DOI":"10.1186\/s10194-020-01149-8"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_024","doi-asserted-by":"crossref","unstructured":"Maarbjerg, S Wolfram, F, Gozalov, A, Olesen, J, Bendtsen, L. Significance of neurovascular contact in classical trigeminal neuralgia. Brain 2015;138:311\u20139. https:\/\/doi.org\/10.1093\/brain\/awu349.","DOI":"10.1093\/brain\/awu349"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_025","doi-asserted-by":"crossref","unstructured":"Eller, JL, Raslan, AM, Burchiel, KJ. Trigeminal neuralgia: definition and classification. Neurosurg Focus 2005;18:E3. https:\/\/doi.org\/10.3171\/foc.2005.18.5.4.","DOI":"10.3171\/foc.2005.18.5.4"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_026","doi-asserted-by":"crossref","unstructured":"Forssell, H, Alstergren, P, Bakke, M, Bj\u00f8rnland, T, J\u00e4\u00e4skel\u00e4inen, SK. Persistent facial pain conditions. Nor Tannlegeforen Tid 2016;126:36\u201342.","DOI":"10.56373\/2016-1-7"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_027","doi-asserted-by":"crossref","unstructured":"Zakrzewska, JM. Differential diagnosis of facial pain and guidelines for management. Br J Anaesth 2013;111:95\u2013104. https:\/\/doi.org\/10.1093\/bja\/aet125.","DOI":"10.1093\/bja\/aet125"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_028","doi-asserted-by":"crossref","unstructured":"Koopman, JS, Dieleman, JP, Huygen, FJ, de Mos, M, Martin, CG, Sturkenboom, MC. Incidence of facial pain in the general population. Pain 2009;147:122\u20137. https:\/\/doi.org\/10.1016\/j.pain.2009.08.023.","DOI":"10.1016\/j.pain.2009.08.023"},{"key":"2025120910043525209_j_sjpain-2021-0045_ref_029","doi-asserted-by":"crossref","unstructured":"Siccoli, MM, Bassetti, CL, Sandor, PS. Facial pain: clinical differential diagnosis. Lancet Neurol 2006;5:257\u201367. https:\/\/doi.org\/10.1016\/S1474-4422(06)70375-1.","DOI":"10.1016\/S1474-4422(06)70375-1"}],"container-title":["Scandinavian Journal of Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/sjpain-2021-0045\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/sjpain-2021-0045\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T12:49:17Z","timestamp":1765284557000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/sjpain-2021-0045\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,2]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,5,20]]},"published-print":{"date-parts":[[2021,10,26]]}},"alternative-id":["10.1515\/sjpain-2021-0045"],"URL":"https:\/\/doi.org\/10.1515\/sjpain-2021-0045","relation":{},"ISSN":["1877-8860","1877-8879"],"issn-type":[{"value":"1877-8860","type":"print"},{"value":"1877-8879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,2]]}}}