Differential Diagnosis for Temple Pain

Single Most Likely Diagnosis

• Tension Headache: This is the most common type of headache and is often described as a dull, aching, or throbbing sensation on one or both sides of the head, including the temples. The justification for this diagnosis is the common presentation of tension headaches in the general population, especially in young adults.

Other Likely Diagnoses

• Migraine: Migraines can cause severe, throbbing pain, often on one side of the head, including the temple area. They can be accompanied by other symptoms like nausea, vomiting, and sensitivity to light and sound.
• Temporal Arteritis: Although more common in older adults, temporal arteritis can cause pain in the temples. It's an inflammation of the blood vessels and can lead to more severe complications if not treated.
• Sinusitis: Inflammation or infection of the sinuses can cause pain in the face, including the temples, especially if the frontal sinuses are involved.

Do Not Miss Diagnoses

• Subarachnoid Hemorrhage: A life-threatening condition that requires immediate medical attention. Although it's less likely, a sudden, severe headache (often described as "the worst headache of my life") could be a sign of bleeding in the brain.
• Stroke or Transient Ischemic Attack (TIA): While less common, a headache can be a symptom of a stroke or TIA, especially if accompanied by other neurological deficits like weakness, numbness, or difficulty speaking.
• Giant Cell Arteritis: Similar to temporal arteritis but can have more widespread symptoms, including fever, weight loss, and visual disturbances.

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 temples.
• Temporal Bone Fracture or Infection: Direct trauma to the head or an infection of the temporal bone could cause localized pain in the temple area.
• Multiple Sclerosis: In rare cases, multiple sclerosis can present with headache, among other neurological symptoms, due to the involvement of the central nervous system.

It's essential for the patient to consult a healthcare professional for a thorough evaluation and diagnosis, as the treatment and management of these conditions can vary significantly.