Trigeminal Neuralgia: Or something else? Differential Diagnosis

Respiratory System (J00-J99)

Eyes and eye appendages (H00-H59).

  • Glaucoma (intraocular pressure elevation).

Cardiovascular system (I00-I99)

  • Aneurysm (vascular dilatation) of cerebral vessels.
  • Apoplexy (stroke)
  • Arteriovenous malformations (AVM) – congenital malformation of blood vessels in which the arteries are directly connected to the veins; these occur mainly in the CNS and facial cranium.
  • Dissection (splitting of vessel wall layers) of the vessels supplying the brain.
  • Intracranial hemorrhage (bleeding within the skull; parenchymal, subarachnoid, sub- and epidural, and supra- and infratentorial hemorrhages)/intracerebral hemorrhage (ICB; cerebral hemorrhage)
  • Sinus vein thrombosis (SVT) – occlusion of a cerebral sinus (large venous blood vessels of the brain arising from duraduplications) by a thrombus (blood clot).
  • Cerebral venous and sinus thrombosis (CVT); symptoms: severe, acute onset, circumscribed headache; possibly also focal or generalized cerebral deficits (incidence (frequency of new cases): < 1.5/100,000 per year)

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).

  • Dental diseases, unspecified

Musculoskeletal system and connective tissue (M00-M99).

  • Arteritis temporalis (synonyms: Arteriitis cranialis; Horton’s disease; giant cell arteritis; Horton-Magath-Brown syndrome) – systemic vasculitis (vascular inflammation) affecting the arteriae temporales (temporal arteries), especially in the elderly.

Neoplasms – tumor diseases (C00-D48).

  • Brain tumors, unspecified
  • Nasal cavity tumors
  • Paranasal sinus tumors

Psyche – nervous system (F00-F99; G00-G99)

  • Atypical facial pain – belongs to the group of primary facial pain (primary without an identifiable cause); occurrence of pain in the area of the face, and therefore in the area of the trigeminal nerve, but not strictly seizure-like (paroxysmal).
  • Chronic hemiparesis headache
  • Chronic paroxysmal hemicrania – headache that has no symptom-free intervals.
  • Cluster headache – typically perceived as a combined headache and facial pain.
  • Encephalitis (inflammation of the brain)
  • Glossopharyngeal neuralgia – belongs to the group of primary facial pain; neuralgia (nerve pain), which can occur due to partial attack pain in the hypopharynx (lowest part of the throat), the base of the tongue, the tonsils (tonsils) and the ear region with appropriate irritation, for example, by chewing, swallowing, speaking (very rare!)
  • Intermedius neuralgia (synonym: geniculate neuralgia) – pain disease from the group of facial diseases; typical feature are strictly unilateral, pain attacks in the area of the external auditory canal.
  • Meningitis (meningitis).
  • Migraine
  • Nasociliary neuralgia – belongs to the group of facial pain; unilateral pain in the inner corner of the eye, radiating to the orbit and bridge of the nose.
  • Postherpetic neuralgia (PHN) – long-lasting nerve pain following herpes zoster infection.
  • Tension headache
  • SUNCT syndrome (shortlasting unilateral neuralgiform headache attacks with conjunctival injection, tearing, sweating and rhinorrhea). – Headache with shorter attacks and higher frequency than cluster headache.
  • Supraorbital neuralgia – neuralgia (nerve pain) in the supraorbital branch of the trigeminal nerve.

Injuries, poisonings and other consequences of external causes (S00-T98).

  • Posttraumatic headache – headache occurring after trauma (injury).