Differential Diagnosis for Facial Pain in a Middle-Aged Woman
Single Most Likely Diagnosis
- Trigeminal Neuralgia: This condition is characterized by sudden, severe, shock-like or stabbing pain in parts of the face, which can be triggered by chewing, talking, or other facial movements. The presence of facial pain that worsens with chewing and the absence of other significant dental issues make this a plausible diagnosis.
Other Likely Diagnoses
- Temporomandibular Joint (TMJ) Disorder: Pain in the TMJ can radiate to the face and is often exacerbated by chewing. Given the patient's symptoms and the recent onset, this is a possible diagnosis.
- Dental Abscess or Infection: Despite good dental hygiene and a recent dental visit, an abscess or infection could cause facial pain, especially if it involves the roots of the teeth or the surrounding bone.
- Oral Cancer: The presence of a mouth ulcer with white induration could suggest oral cancer, particularly if the ulcer is not healing. This diagnosis needs consideration, especially in a middle-aged individual.
Do Not Miss Diagnoses
- Lung Cancer with Metastasis: Although less common, lung cancer can metastasize to the face or jaw, causing pain. This diagnosis is critical to consider due to its severe implications.
- Multiple Sclerosis: This condition can cause trigeminal neuralgia among other symptoms. Early diagnosis is crucial for management.
- Giant Cell Arteritis: This condition can cause facial pain, especially in the jaw, and is associated with other symptoms like headache and visual disturbances. It's a medical emergency due to the risk of blindness.
Rare Diagnoses
- Sarcoidosis: This autoimmune disease can cause facial pain among a myriad of other symptoms, including skin lesions and lung issues.
- Eagle Syndrome: An elongated styloid process can cause facial pain, especially with swallowing or chewing. It's a rare condition but should be considered in the differential diagnosis of facial pain.
- Neurosyphilis: In its late stages, syphilis can cause a variety of neurological symptoms, including facial pain. Given the broad range of symptoms it can cause, it remains a rare but possible diagnosis.