Differential Diagnosis for Intermittent Unilateral Cheek Numbness
Single Most Likely Diagnosis
- Trigeminal Neuralgia: This condition is characterized by sudden, severe, and intermittent pain or numbness in the face, often affecting one side of the cheek. It is a common cause of unilateral facial numbness and is usually related to compression of the trigeminal nerve.
Other Likely Diagnoses
- Multiple Sclerosis: This autoimmune disease can cause numbness or tingling in the face, including the cheek, due to lesions in the central nervous system affecting the trigeminal nerve pathways.
- Dental Problems: Issues such as tooth abscesses, gum disease, or dental procedures can cause referred pain or numbness to the cheek area.
- Sinusitis: Inflammation of the sinuses can cause facial pain or numbness, especially if the maxillary sinus is involved, which is located in the cheek area.
Do Not Miss Diagnoses
- Stroke or Transient Ischemic Attack (TIA): Although less common, facial numbness can be a symptom of a stroke or TIA, especially if accompanied by other neurological deficits. Early recognition is crucial for timely intervention.
- Lyme Disease: Neurological manifestations of Lyme disease can include facial numbness or palsy, making it a critical diagnosis not to miss, especially in endemic areas.
- Cancer (e.g., Pancreatic Cancer): Certain cancers, when they metastasize or directly invade nerves, can cause facial numbness. For example, pancreatic cancer can cause trigeminal nerve dysfunction.
Rare Diagnoses
- Sarcoidosis: This autoimmune disease can affect any part of the body, including the nerves, leading to facial numbness.
- Vitamin Deficiencies (e.g., Vitamin B12 Deficiency): Deficiencies in certain vitamins can lead to neurological symptoms, including numbness or tingling in the face.
- Herpes Zoster (Shingles): While more commonly associated with a rash, shingles can cause numbness or pain in the area supplied by the affected nerve, including the face, before the rash appears.