Differential Diagnoses of Trigeminal Neuralgias

Abstract

The main differential diagnoses are the trigeminal pains linked to an identifiable pathology or an injury to the trigeminal system or its territory. They belong to two different entities. The first one corresponds to the secondary trigeminal neuralgias, the second to the painful trigeminal neuropathies. Other diagnoses not directly related to pathologies of the trigeminal nerve may resemble trigeminal neuralgia, most frequently the trigeminal autonomic cephalalgias in their various forms. Most other neuralgias in the cephalic region are rarely problematic, with the exception of the vago-glossopharyngeal neuralgia which can be sometimes intricated with trigeminal components. The frequent occipital neuralgia is generally quite different in topography. The most misleading differential diagnosis is surely the so-called atypical facial pain, nowadays termed persistent idiopathic facial pain, especially when the trigeminal neuralgia has an atypical presentation.