How is trigeminal neuralgia (TN) differentiated from atypical face pain?

Updated: Jul 11, 2019
  • Author: Manish K Singh, MD; Chief Editor: Robert A Egan, MD  more...
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According to Turp and Gobetti, atypical face pain usually extends beyond the distribution of the fifth cranial nerve, is rarely triggered, and presents with a steady unrelenting discomfort lasting hours to days. [19] See Table 2, below.

In persistent idiopathic facial pain, psychiatric disturbances are associated with pain that is of vague localization and long duration (usually chronic and daily). In Raeder syndrome (paratrigeminal neuralgia), ophthalmoparesis is present. In current practice, Raeder syndrome is believed to essentially be carotid dissection. Tolosa-Hunt syndrome (ophthalmoplegia) presents with pain of longer duration but that is not triggerable; cranial nerve deficits are observed. Short-lasting, unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) present with pain of longer duration (2-3 min) and associated prominent autonomic symptoms (eg, lacrimation, rhinorrhea). [20]

Temporomandibular joint pain and dental problems in the evaluation of trigeminal neuralgia.

Table 2. Distinguishing Features Between Trigeminal Neuralgia and Atypical Facial Pain (Open Table in a new window)


Trigeminal Neuralgia

Atypical Facial Pain




Main location

Trigeminal area

Face, neck, ear

Pain duration

Seconds to 2 minutes

Hours to days


Electric jerks, stabbing

Throbbing, dull

Pain intensity


Mild to moderate

Provoking factors

Light touch, washing, shaving, eating, talking

Stress, cold

Associated symptoms


Sensory abnormalities

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