Trigeminal neuralgia is similar to many other conditions and is often misdiagnosed. Trigeminal neuralgia pain is mostly within the trigeminal nerve, with specific areas of onset above and below the eyes, above and below the cheekbones, and above and below the mouth. Most cases of trigeminal neuralgia are misdiagnosed as a toothache, but there is a difference. Toothache is often accompanied by swollen and painful gums, while trigeminal neuralgia is different. 1, toothache: trigeminal neuralgia is often misdiagnosed as a toothache, the pain caused by dental disease is persistent pain, mostly confined to the gums, localized toothache and pathogenic lesions, X-rays and dental examination can confirm the diagnosis. 2, paranasal sinusitis: such as frontal sinusitis, maxillary sinusitis, etc., for the limited persistent pain, there may be fever, nasal congestion, thick mucus and local pressure and pain. 3.Glaucoma: acute attack of unilateral glaucoma is misdiagnosed as the pain of the 1st branch of the trigeminal nerve. Glaucoma is persistent pain without radiation, and there may be vomiting, accompanied by congestion of the conjunctiva of the globe, shallowing of the anterior chamber, and increase in intraocular pressure. 4.Temporomandibular arthritis: the pain is confined to the temporomandibular joint area, which is persistent, and there is pressure pain in the joint area, joint movement disorder, and the pain is closely related to the jaw movement, and it is feasible to assist the diagnosis by imaging and specialized examination of temporomandibular joint disease. Migraine: the pain is beyond the range of trigeminal nerve, and there are visual aura before the attack, such as blurred vision, dark spots, etc., which may be accompanied by vomiting. The pain is persistent and long, often 1-2 days. 6.Trigeminal neuritis: short history, persistent pain, hypersensitivity or hypesthesia in the distribution area of the trigeminal nerve, which may be accompanied by dyskinesia, and obvious pressure in the affected trigeminal nerve branches. Neuritis mostly develops after cold or paranasal sinusitis. 7, Cerebellar pontine angle tumor: the pain episodes can be the same or atypical with trigeminal neuralgia, but it is mostly seen in young people under 30 years old, with hypesthesia in trigeminal nerve distribution area, and other symptoms and signs of cerebellar pontine angle can be produced gradually. Cholesteatoma is common, followed by meningioma and auditory nerve sheath tumor, the latter two have other cerebral nerve involvement, ataxia and increased intracranial pressure are more obvious.X-ray film, CT intracranial scan and MRI can help to confirm the diagnosis. 8, Tumor invading skull base: the most common tumor is nasopharyngeal carcinoma, often accompanied by epistaxis and nasal congestion, which can invade most of the cerebral nerves, and cervical lymph node enlargement. Nasopharyngeal examination, biopsy, imaging of the skull base, CT and MRI examination can confirm the diagnosis. 9.Glossopharyngeal neuralgia: It is easy to be mixed with the pain of the 3rd branch of trigeminal nerve, and the sites of glossopharyngeal neuralgia are different, such as the soft palate, tonsils, pharyngeal tongue wall, root of the tongue, and external auditory canal. The pain is induced by swallowing movements. The pain can disappear after spraying the pharyngeal area with 1% Pantocaine or cocaine. 10.Tumor of trigeminal semilunar ganglion area: ganglion cell tumor, chordoma, meningioma of Mai’s fossa, etc. It may have persistent pain, and the patient’s trigeminal nerve sensory and motor disorder is obvious. The patient may have persistent pain and obvious trigeminal nerve sensory and motor disorders. X-ray of skull base may have bone destruction and other changes. Facial neuralgia: mostly seen in young people, the pain is beyond the range of trigeminal nerve, and can extend to the back of ear, top of the head, occipital neck, and even the shoulder, etc. The pain is persistent and can last for hours. Pain persistent, up to a few hours, unrelated to movement, not afraid to touch, can be bilateral pain, night can be heavier. Warm tips: Trigeminal neuralgia has its own characteristics and symptoms, so careful identification will avoid misdiagnosis. In life, many patients lack of knowledge of this disease, the doctor asked when they can not say, resulting in misdiagnosis. So it is very important to know something about trigeminal neuralgia!