How do you tel the difference between migraine, sinuses, and the trigeminial nerve since they are on the same nerve path?

See a specialist: for evaluation and proper diagnosis and treatment. For example, it has been estimated that approximately 70% of migraine headaches overlie the sinuses and are triggered by changes in barometric pressure. These patients actually suffer from migraine but usually are diagnosed with sinus headache and use over-the counter vasoconstrictor agents for relief.