Differential Diagnosis for Numbness and Paresthesia to One Side of Face

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. Numbness and paresthesia can also occur, making it a common diagnosis for unilateral facial symptoms.

Other Likely Diagnoses

• Bell's Palsy: An idiopathic condition that causes paralysis or weakness of the facial muscles, often presenting with numbness or altered sensation on one side of the face.
• Multiple Sclerosis: An autoimmune disease that affects the brain and spinal cord, leading to various neurological symptoms, including numbness and paresthesia in the face.
• Stroke or Transient Ischemic Attack (TIA): Although more commonly associated with motor deficits, strokes or TIAs can cause sensory symptoms like numbness and paresthesia, especially if the brainstem or specific sensory pathways are involved.
• Trigeminal Neuropathy: Damage to the trigeminal nerve can cause numbness, paresthesia, or pain on one side of the face.

Do Not Miss Diagnoses

• Brain Tumor: Tumors in the brain, especially those affecting the trigeminal nerve or brainstem, can cause facial numbness and paresthesia. Early detection is crucial for treatment and prognosis.
• Lyme Disease: Neurological manifestations of Lyme disease can include facial palsy and, less commonly, numbness or paresthesia, especially if the disease progresses without treatment.
• Sarcoidosis: A systemic disease that can affect the nervous system, causing various symptoms, including facial numbness and paresthesia due to inflammation of the nerves.

Rare Diagnoses

• Sjögren's Syndrome: An autoimmune disorder that primarily affects the glands that produce tears and saliva but can also have neurological manifestations, including neuropathies that might cause facial numbness.
• Vitamin Deficiencies (e.g., Vitamin B12 Deficiency): Although more commonly associated with systemic or peripheral neuropathic symptoms, severe vitamin deficiencies can lead to a wide range of neurological symptoms, including numbness and paresthesia in unusual distributions.
• Mitochondrial Disorders: A group of disorders caused by dysfunctional mitochondria, which can lead to a variety of neurological symptoms, including neuropathies and unusual sensory disturbances.