{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:20:28Z","timestamp":1790889628737,"version":"4.1.0"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2009,12]]},"abstract":"\n Object<\/jats:title>\n Trigeminal neuralgia (TN) presents a diagnostic challenge because of the variety of symptoms, findings during microvascular decompression (MVD), and postsurgical outcomes observed among patients who suffer from this disorder. Recently, a new paradigm for classification of TN was proposed, based on the quality of pain. This study represents the first clinical analysis of this paradigm.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The authors analyzed 144 consecutive cases involving patients who underwent MVD for TN. Preoperative symptoms were classified into 1 of 2 categories based on the preponderance of shocklike (Type 1 TN) or constant (Type 2 TN) pain. Analysis of clinical characteristics, neurovascular pathology, and postoperative outcome was performed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Compared with Type 2 TN, Type 1 TN patients were older, were more likely to have right-sided symptoms, and reported a shorter duration of symptoms prior to evaluation. Previous treatment by percutaneous or radiosurgical procedures was not a predictor of symptoms, surgical findings, or outcome (p = 0.48). Type 1 TN was significantly more likely to be associated with arterial compression. Venous or no compression was more common among Type 2 TN patients (p < 0.01). Type 1 TN patients were also more likely to be pain-free immediately after surgery, and less likely to have a recurrence of pain within 2 years (p < 0.05). Although a subset of patients progressed from Type 1 to Type 2 TN over time, their pathological and prognostic profiles nevertheless resembled those of Type 1 TN.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Type 1 and Type 2 TN represent distinct clinical, pathological, and prognostic entities. Classification of patients according to this paradigm should be helpful to determine how best to treat patients with this disorder.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2008.6.17604","type":"journal-article","created":{"date-parts":[[2009,4,24]],"date-time":"2009-04-24T10:03:55Z","timestamp":1240567435000},"page":"1231-1234","source":"Crossref","is-referenced-by-count":97,"title":["Classification of trigeminal neuralgia: clinical, therapeutic, and prognostic implications in a series of 144 patients undergoing microvascular decompression"],"prefix":"10.3171","volume":"111","author":[{"given":"Jonathan P.","family":"Miller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feridun","family":"Acar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim J.","family":"Burchiel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1111231","series-title":"N Engl J Med","first-page":"1077","article-title":"The long-term outcome of microvascular decompression for trigeminal neuralgia","volume":"334","author":"Barker","year":"1996"},{"key":"b2-1111231","series-title":"J Neurosurg","first-page":"865","article-title":"Intracranial tumors in patients with facial pain","volume":"64","author":"Bullitt","year":"1986"},{"key":"b3-1111231","series-title":"J Neurosurg","first-page":"674","article-title":"Abnormal impulse generation in focally demyelinated trigeminal roots","volume":"53","author":"Burchiel","year":"1980"},{"key":"b4-1111231","series-title":"Neurosurgery","first-page":"1164","article-title":"A new classification for facial pain","volume":"53","author":"Burchiel","year":"2003"},{"key":"b5-1111231","series-title":"Neurosurgery","first-page":"152","article-title":"On the natural history of trigeminal neuralgia","volume":"46","author":"Burchiel","year":"2000"},{"key":"b6-1111231","series-title":"J Neurosurg","first-page":"532","article-title":"Mechanism of trigeminal neuralgia: an ultrastructural analysis of trigeminal root specimens obtained during microvascular decompression surgery","volume":"96","author":"Devor","year":"2002"},{"issue":"5","key":"b7-1111231","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Trigeminal neuralgia: definition and classification","volume":"18","author":"Eller","year":"2005"},{"key":"b8-1111231","series-title":"Trigeminal Neuralgia: Current Concepts Regarding Pathogenesis and Treatment","author":"Fromm","year":"1991"},{"key":"b9-1111231","series-title":"Neurosurgery","first-page":"620","article-title":"Trigeminal neuralgia resulting from infarction of the root entry zone of the trigeminal nerve: case report","volume":"43","author":"Golby","year":"1998"},{"key":"b10-1111231","series-title":"J Neurosurg","first-page":"381","article-title":"Microvascular relations of the trigeminal nerve. An anatomical study with clinical correlation","volume":"52","author":"Haines","year":"1980"},{"key":"b11-1111231","series-title":"J Neurosurg","first-page":"948","article-title":"Neurovascular compression in trigeminal neuralgia: a clinical and anatomical study","volume":"76","author":"Hamlyn","year":"1992"},{"key":"b12-1111231","series-title":"Neurosurgery","first-page":"299","article-title":"Pathological findings associated with trigeminal neuralgia caused by vascular compression","volume":"35","author":"Hilton","year":"1994"},{"issue":"Suppl","key":"b13-1111231","series-title":"J Neurosurg","first-page":"159","article-title":"Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia","volume":"26","author":"Jannetta","year":"1967"},{"key":"b14-1111231","series-title":"Neurology","first-page":"1641","article-title":"Recovery of nerve conduction following microvascular decompression for trigeminal neuralgia","volume":"51","author":"Leandri","year":"1998"},{"key":"b15-1111231","series-title":"Surg Neurol","first-page":"400","article-title":"Trigeminal neuralgia: what are the important factors for good operative outcomes with microvascular decompression","volume":"62","author":"Li","year":"2004"},{"key":"b16-1111231","series-title":"Br J Anaesth","first-page":"117","article-title":"Trigeminal neuralgia\u2013pathophysiology, diagnosis and current treatment","volume":"87","author":"Nurmikko","year":"2001"},{"key":"b17-1111231","series-title":"J Neurosurg","first-page":"527","article-title":"Predictors of outcome in surgically managed patients with typical and atypical trigeminal neuralgia: comparison of results following microvascular decompression","volume":"96","author":"Tyler-Kabara","year":"2002"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/111\/6\/article-p1231.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/111\/6\/article-p1231.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/111\/6\/article-p1231.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T05:56:32Z","timestamp":1679896592000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/111\/6\/article-p1231.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2009,12]]},"references-count":17,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2008.6.17604","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,12]]}}}