Morton's Neuroma: This condition is characterized by a benign neuroma of an intermetatarsal plantar nerve, typically affecting the nerve between the third and fourth toes but can also affect other toes. The symptoms include sharp, burning pain in the ball of the foot, which can radiate to the toes, matching the description of intermittent causalgia of the dorsomedial halluc.

Gout: This is a form of inflammatory arthritis characterized by sudden, severe attacks of pain, swelling, redness, and tenderness. It often affects the joint at the base of the big toe, which could cause pain in the dorsomedial halluc area.
Hallux Valgus: A condition where the big toe points towards the second toe, potentially causing friction and pain on the dorsomedial aspect of the hallux due to shoe pressure or abnormal gait mechanics.
Intermetatarsal Bursitis: Inflammation of the bursae between the metatarsal bones can cause pain in the ball of the foot, potentially radiating to the toes, including the big toe.

Deep Vein Thrombosis (DVT): Although less common, DVT can cause leg pain and swelling, and in rare cases, might refer pain to the foot or toes. Missing this diagnosis could be catastrophic due to the risk of pulmonary embolism.
Osteoid Osteoma: A benign bone tumor that can cause severe, intermittent pain, typically worse at night and relieved by NSAIDs. It's crucial not to miss this diagnosis as it can significantly impact quality of life and may require surgical intervention.
Infection (e.g., Osteomyelitis, Cellulitis): Infections in the foot can cause severe pain, redness, and swelling. Early diagnosis and treatment are crucial to prevent serious complications.

Erythromelalgia: A disorder characterized by burning pain, heat, and redness in the hands and feet. It's a rare condition but could potentially cause the described symptoms.
Complex Regional Pain Syndrome (CRPS): A chronic pain condition that most often affects one of the arms, legs, hands, or feet after an injury or trauma. It's rare but could be considered in the differential diagnosis for intermittent causalgia, especially if there's a history of trauma.
Neoplastic Processes: Rarely, tumors (benign or malignant) in the foot or nerves supplying the foot could cause intermittent pain. Examples include schwannomas or other soft tissue tumors.