Differential Diagnosis for Tingling in Lower Lip and Tongue

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 tingling or numbness in areas innervated by the trigeminal nerve, including the lower lip and tongue, due to its involvement.

Other Likely Diagnoses

• Multiple Sclerosis (MS): MS is an autoimmune disease that affects the brain and spinal cord. It can cause a wide range of neurological symptoms, including numbness, tingling, or weakness in one or more limbs, which can include the face, leading to symptoms like tingling in the lower lip and tongue.
• Hyperventilation Syndrome: This condition can lead to respiratory alkalosis, causing tingling sensations around the mouth and in the extremities due to the reduction in carbon dioxide levels in the blood.
• Vitamin B12 Deficiency: A deficiency in vitamin B12 can cause neurological symptoms, including numbness or tingling in the hands and feet, and less commonly, in the face, including the lower lip and tongue.

Do Not Miss Diagnoses

• Stroke or Transient Ischemic Attack (TIA): Although less common, a stroke or TIA can cause sudden numbness or tingling, especially if the brainstem or areas responsible for facial sensation are involved. This is a medical emergency.
• Lyme Disease: In its later stages, Lyme disease can cause neurological problems, including numbness, tingling, and pain in the face, which could involve the lower lip and tongue.
• Sjögren's Syndrome: An autoimmune disorder that can cause nerve damage, leading to numbness or tingling in various parts of the body, including the face.

Rare Diagnoses

• Sarcoidosis: A condition where inflammatory cells form lumps known as granulomas in various parts of the body, including the nervous system, potentially causing numbness or tingling.
• Peripheral Neuropathy due to Other Causes: Such as diabetes, alcohol abuse, or certain toxins and medications, which can cause tingling sensations in various parts of the body, including the face.
• Tumors Affecting the Trigeminal Nerve or Brainstem: Although rare, tumors in these areas can cause a variety of neurological symptoms, including tingling or numbness in the face.