Having arrived at Baku's Bakcell Arena hoping to show last month's loss to Luxembourg was a blip, Michael O'Neill's side instead added another depressing result to their Group F hall of shame.
Yet at the half-time break, it seemed as though they were well set to claim a positive result.
Paterson and strike partner Jamie Ward both got on the end of good opportunities but could not provide the killer touch.
And although they went in at the interval confident their luck would change, the hosts pounced with a 58th minute goal from Rufat Dadashov and it only got worse from there.
Paterson lashed the woodwork with a powerful strike in the 88th minute and as the game entered added time Jonny Evans was sent off for a professional foul, as well as conceding a free-kick which Mahir Shukurov bent into the top corner.
Huddersfield forward Paterson revealed the players struggled to get their heads around their fate.
"If you watched that game you're probably scratching your head wondering how have we lost 2-0. We are," he said.
"People might see the result and say 'Northern Ireland lost 2-0, what a poor result that is' but they don't see how we've played.
"Saying that, we've only got ourselves to blame. We dominated the game for 45 minutes but didn't take our chances and their goalkeeper played very well.