Headaches that feel like pins and needles may be neuralgia, which commonly includes trigeminal neuralgia, greater occipital neuralgia, and temporal neuralgia in clinical practice. Neuralgia is divided into primary and secondary. In primary neuralgia, the exact etiology is not clear, and it may be caused by the change of nerve demyelination, which causes abnormal nerve discharge. Symptomatic treatment is usually given mainly with oral carbamazepine, oxcarbazepine, or oral phenytoin sodium. Patients generally have episodic pain of short duration, which can last from a few seconds to 1-2 minutes, and can stop suddenly. Secondary neuralgia usually has a clear etiology and most patients have headaches of longer duration. Common etiologies include cranial tumors and may also be due to multiple sclerosis, which is mainly treated by giving etiology. Alternatively, it may be caused by a primary headache disorder, which is commonly seen clinically as cluster headache. This disease is a kind of neurovascular headache. Patients mainly present with persistent drilling, pulling and tearing pain in the deep part of one eye and the periorbital area, and can also have pins and needles pain, and the headache is relatively severe. The headache can be accompanied by conjunctival congestion, nasal congestion and tearing, usually lasting from 15 to 180 minutes, and can stop suddenly or be relieved slowly, mainly by giving symptomatic treatment.