Differential Diagnosis for Pain in the Temple Above the Eye
Single Most Likely Diagnosis
- Tension Headache: This is the most common type of headache and often presents with pain on one or both sides of the head, including the temples. The pain is usually mild to moderate, described as a band or a squeezing sensation around the forehead, and can be exacerbated by stress or muscle tension.
Other Likely Diagnoses
- Migraine: Migraines can cause severe, throbbing pain, often on one side of the head, which may include the temple area. They can be accompanied by other symptoms like sensitivity to light, sound, or nausea.
- Cluster Headache: These are extremely painful headaches that occur in cycles or clusters, often waking the patient from sleep. The pain is typically on one side of the head, centered around the eye, and can radiate to the temple.
- Temporal Arteritis: Also known as giant cell arteritis, this condition involves inflammation of the blood vessels, particularly those in the temples. It's more common in older adults and can cause pain in the temples, jaw claudication, and visual disturbances.
- Sinusitis: Inflammation or infection of the sinuses can cause pain in the face, including the area above the eyes and temples, especially if the frontal sinuses are involved.
Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: Although rare, a sudden, severe headache (often described as "the worst headache of my life") could indicate bleeding into the space surrounding the brain, which is a medical emergency.
- Stroke or Transient Ischemic Attack (TIA): Pain in the head, including the temple area, can sometimes be a symptom of a stroke or TIA, especially if accompanied by other neurological deficits like weakness, numbness, or difficulty with speech or vision.
- Temporal Arteritis with Visual Loss: If left untreated, temporal arteritis can lead to blindness due to ischemic optic neuropathy, making prompt diagnosis and treatment critical.
Rare Diagnoses
- Trigeminal Neuralgia: A chronic pain condition that affects the trigeminal nerve, which can cause intense shock-like or stabbing pain in parts of the face, including the temple area, usually triggered by light touch.
- Occipital Neuralgia: Involves the occipital nerves and can cause pain in the back and top of the head, which may radiate to the temple area, often described as sharp, stabbing, or electric shock-like.
- Hemicrania Continua: A rare form of headache that is continuous and typically affects one side of the head, including the temple, with periods of exacerbation. It's often accompanied by autonomic symptoms like nasal congestion or lacrimation.