Table 2.

Rare conditions that may be difficult to distinguish from trigeminal neuralgia (which has been included for comparison)

Diagnosis	Important features	Typical duration of attack	Range of duration
Trigeminal neuralgia	See text; trigeminal neuralgia rarely affects the ophthalmic division of the trigeminal nerve, so forehead pain is rarely trigeminal neuralgia	4 seconds	2-120 seconds
Primary stabbing headache	Also known as “ice pick headache;” short stabs of pain in temporal region usually lasting a second or less5	1 second	1-10 seconds
Short lasting unilateral neuralgiform headache attacks with conjuctival injection and tearing*	Brief attacks of severe unilateral periorbital and forehead pain associated with ipsilateral conjuctival injection and lacrimation	40 seconds	5-250 seconds
Chronic paroxysmal hemicrania*	Stabbing, throbbing, or boring pain that affects the eye and forehead; may have 5-10 attacks daily	5-15 seconds	2-46 seconds
Cluster headache*	Sever unilateral forehead pain, often associated with hyperactivity during the attack, ipsilateral conjunctival injection, and Horner's syndrome	40 minutes	8-238 minutes
Trigeminal neuropathy	Continuous pain with sharp exacerbations; pronounced sensory deficit	Continuous
Post-herpetic neuralgia	Seen after shingles (usually more than 3 months after); often affects forehead; continuous burning pain with sharp exacerbations	Continuous
Occipital neuralgia	Pain similar to that of trigeminal neuralgia but affects back of head	Seconds	Not available
Glossopharyngeal neuralgia	Pain very similar to that of trigeminal neuralgia but affects posterior third of the tongue, tonsils, and pharynx	Seconds	Not available

*Grouped together as trigeminal autonomic cephalalgias.