Differential Diagnosis for Numbness and Burning to One Side of Face

Single Most Likely Diagnosis

• Trigeminal Neuralgia: This condition is characterized by sudden, severe, and stabbing pain or numbness and burning sensation on one side of the face, typically triggered by light touch or other stimuli. It affects the trigeminal nerve, which is responsible for sensation in the face.

Other Likely Diagnoses

• Multiple Sclerosis: This autoimmune disease can cause numbness, burning, or other abnormal sensations on one side of the face due to lesions in the central nervous system affecting the trigeminal nerve pathways.
• Stroke or Transient Ischemic Attack (TIA): Although less common for facial numbness to be the sole symptom, a stroke or TIA can cause sudden numbness or burning sensations on one side of the face due to vascular compromise in areas of the brain responsible for facial sensation.
• Lyme Disease: In its early stages, Lyme disease can cause facial palsy (Bell's palsy-like symptoms) and sometimes numbness or burning sensations on one side of the face due to inflammation of the nerves.

Do Not Miss Diagnoses

• Brain Tumor: Although rare, a tumor in the brain, especially one affecting the trigeminal nerve or its pathways, can cause progressive numbness or burning sensations on one side of the face. Early detection is crucial for treatment and prognosis.
• Cavernous Sinus Thrombosis: This is a rare but potentially life-threatening condition involving a blood clot in the cavernous sinus, which can cause facial numbness among other symptoms like headache and eye findings.
• Giant Cell Arteritis: This condition can lead to facial pain and numbness, especially in older adults, and is a medical emergency due to the risk of vision loss if not promptly treated.

Rare Diagnoses

• Sarcoidosis: A systemic disease that can affect any part of the body, including the nerves, leading to numbness or burning sensations on one side of the face due to granulomatous inflammation.
• Vitamin Deficiencies (e.g., Vitamin B12 Deficiency): While more commonly associated with systemic or bilateral symptoms, severe vitamin deficiencies can occasionally cause localized neurological symptoms, including numbness or burning sensations.
• Herpes Zoster (Shingles): Typically presents with a rash, but in some cases, especially before the rash appears (pre-herpetic neuralgia), it can cause burning pain or numbness on one side of the face, particularly in the distribution of the trigeminal nerve.