Differential Diagnosis for Paresthesia and Numbness in Lip

Single Most Likely Diagnosis

• Trigeminal Neuralgia: This condition is characterized by sudden, severe, and shock-like pain around the eyes, lips, or nose mainly because of abnormal blood vessels pressing on the trigeminal nerve in the head. However, it can also cause paresthesia and numbness, especially if the nerve is compressed or irritated.

Other Likely Diagnoses

• Multiple Sclerosis: An autoimmune disease that affects the brain and spinal cord, leading to various neurological symptoms, including numbness or tingling in the face, which could include the lip area.
• Peripheral Neuropathy: Damage to the peripheral nerves can cause numbness, tingling, and paresthesia in various parts of the body, including the face and lips, often due to diabetes, vitamin deficiencies, or alcohol abuse.
• Dental Problems: Issues like an abscess, infection, or trauma to the teeth or gums can cause referred pain or numbness to the lip area due to the shared nerve supply.

Do Not Miss Diagnoses

• Stroke or Transient Ischemic Attack (TIA): Although less common, sudden onset of facial numbness, including the lip area, could be a symptom of a stroke or TIA, especially if accompanied by other symptoms like facial weakness, speech difficulties, or limb numbness.
• Lyme Disease: In its later stages, Lyme disease can cause neurological problems, including numbness or tingling in the face, making it a critical diagnosis not to miss due to its potential for serious complications if left untreated.
• Sjögren's Syndrome: An autoimmune disorder that can cause nerve damage, leading to numbness or tingling sensations, including in the face and lips, alongside its more common symptoms of dry eyes and mouth.

Rare Diagnoses

• Sarcoidosis: A condition where inflammatory cells form lumps known as granulomas in various parts of the body, including the nerves, which can lead to numbness or tingling, though facial involvement is less common.
• Lip Cancer or Other Oral Cancers: In rare cases, numbness in the lip could be a symptom of cancer affecting the nerves, though this would typically be accompanied by other signs like a lump, ulcer, or unexplained bleeding.
• Vitamin Deficiencies (e.g., Vitamin B12 Deficiency): While more commonly associated with generalized symptoms or numbness in the limbs, severe vitamin deficiencies can lead to neurological symptoms, including facial numbness, though this is less common.