Differential Diagnosis for Facial Pain Radiating Up the Right Side of the Face When Swallowing
Single Most Likely Diagnosis
- Temporomandibular Joint (TMJ) Disorder: Given the patient's history of TMJ and the nature of the pain radiating up the face when swallowing, this is the most plausible diagnosis. TMJ disorders can cause referred pain to the face, especially during actions that involve the jaw, such as swallowing.
Other Likely Diagnoses
- Trigeminal Neuralgia: This condition involves sudden, severe, shock-like pain around the eyes, lips, or nose mainly because of abnormal blood vessels pressing on the trigeminal nerve in the head. Swallowing could potentially trigger this pain if it irritates the nerve.
- Eagle Syndrome: This is a condition where the styloid process (a pointed piece of bone just below the ear) is elongated or the stylohyoid ligament is calcified, which can cause facial pain, especially when swallowing, due to the irritation of nearby nerves.
- Dental Issues: Problems such as abscesses, impacted teeth, or gum disease can cause pain that radiates to the face, potentially worsening with actions like swallowing.
Do Not Miss Diagnoses
- Stroke or Transient Ischemic Attack (TIA): Although less likely, facial pain, especially if accompanied by other neurological symptoms like weakness, numbness, or difficulty speaking, could be indicative of a stroke or TIA. The sudden onset of such symptoms warrants immediate medical attention.
- Multiple Sclerosis: This chronic disease affects the central nervous system, and one of its many possible symptoms can be facial pain, which might be triggered by specific actions, including swallowing.
- Giant Cell Arteritis: An inflammation of the arteries in the head, which can cause severe headaches, facial pain, and jaw claudication (pain when chewing or swallowing).
Rare Diagnoses
- Raeder Syndrome: A rare condition characterized by a combination of symptoms including facial pain, usually in the distribution of the trigeminal nerve, and sympathetic dysfunction (e.g., ptosis, miosis) on the same side of the face.
- Tolosa-Hunt Syndrome: A rare disorder characterized by severe and unilateral headaches with extraocular palsies, which could potentially cause facial pain, especially if the nerves involved are irritated during swallowing.