Table 3

Differential diagnosis between trigeminal neuralgia (TN) with concomitant facial pain and other trigeminal neuropathic conditions

FeaturesTN with concomitant persistent facial painIdiopathic neuropathic pain*Neuropathic pain with identifiable cause†Persistent idiopathic facial pain
Precipitating factorNoNoYes (trauma, viral, inflammatory)No (possible stress)
Pain locationExtra/intraoralExtra/intraoralExtra/intraoralExtraoral
Laterality and trigeminal distributionUnilateral
Dermatomal
Unilateral
Dermatomal
Unilateral
Dermatomal
Often bilateral
Non-dermatomal
Pain severitySevere–very severeMild to severeMild to severeMild to severe
Other sensory symptomsNoneYesYesNone
Cutaneous/intraoral triggersPresentYes, but rarePresentNone
Effective treatmentsCarbamazepineTricyclic antidepressants, gabapentinoidsTricyclic antidepressants, gabapentinoidsUnclear
  • *Includes persistent dentoalveolar pain, atypical odontalgia, phantom tooth pain in which the pain location is intraoral only.

  • †This term mainly includes painful post-traumatic trigeminal neuropathy and post-herpetic neuropathic pain.