How is trigeminal neuralgia (TN) differentiated from migraine and cluster headaches?

Updated: Jul 11, 2019
  • Author: Manish K Singh, MD; Chief Editor: Robert A Egan, MD  more...
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Answer

Migraine, cluster headaches, and atypical face pain

Migraine and cluster headaches may produce severe unilateral pain, but unlike trigeminal neuralgia, these conditions are not triggered by movement or contact with the face nor do they respond promptly to carbamazepine. See Table 1, below.

Table 1. Characteristic Features of 3 Common Craniofacial Pains (Open Table in a new window)

Condition

Male:Female Ratio

Age of onset, y

Localization

Accompanying Symptoms

Attack Duration

Cycles

Provocation

Trigeminal neuralgia

1:2

>50

Unilateral

None

Seconds

Month intervals

Trigger zones

Cluster headache

1:6-9

30-40

Always unilateral

Horner syndrome, conjunctival injection, epiphora

15-180 minutes

Clusters with weeks to months intervals

Nocturnal attacks

Migraine

1:1

10-20

Variable

Photophobia, phonophobia, gastrointestinal symptoms

4-72 hours

Days to weeks intervals

Variable


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