Differential Diagnosis for Severe Facial Pain

• Single most likely diagnosis
  • Trigeminal Neuralgia: This condition is characterized by sudden, severe, and sharp pain in parts of the face, which can be triggered by light touch or other stimuli. It is a common cause of severe facial pain and has a distinct presentation that often leads to its consideration as a primary diagnosis.
• Other Likely diagnoses
  • Dental Problems (e.g., Abscess, Impaction): Dental issues are a frequent cause of facial pain, ranging from mild to severe. Conditions such as tooth abscesses or impacted teeth can cause significant pain and are often considered in the differential diagnosis due to their prevalence.
  • Sinusitis: Inflammation of the sinuses can cause pain in the face, particularly in the areas surrounding the eyes and nose. This condition is relatively common and can cause severe pain, making it a likely consideration.
  • Temporomandibular Joint (TMJ) Disorder: TMJ disorders can cause pain in the jaw, face, and surrounding areas, often due to issues with the joint or the muscles of mastication. This condition is common and can lead to severe pain, especially with jaw movement.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Acute Angle-Closure Glaucoma: Although less common, this condition can cause severe eye and facial pain and is an emergency that requires immediate treatment to prevent vision loss.
  • Cavernous Sinus Thrombosis: A rare but potentially life-threatening condition that can cause facial pain, among other symptoms. It is crucial to consider this diagnosis due to its severe consequences if left untreated.
  • Giant Cell Arteritis: This condition can cause facial pain, especially in the temple area, and is associated with other symptoms like visual disturbances and jaw claudication. It is essential to diagnose promptly to prevent complications such as blindness.
• Rare diagnoses
  • Cluster Headaches: These are extremely painful headaches that occur in cycles or clusters, often on one side of the head, and can be accompanied by facial pain. They are less common than other headache disorders but are known for their severity.
  • Tolosa-Hunt Syndrome: A rare condition characterized by severe and unilateral headaches with extraocular palsies, which can cause facial pain. It is due to nonspecific inflammation of the cavernous sinus or superior orbital fissure.
  • Raeder's Syndrome: A rare condition that presents with a combination of facial pain, ptosis, and miosis, often due to a lesion in the middle cranial fossa affecting the sympathetic nerves.