Differential Diagnosis for 36 year old female with left facial numbness and sinus congestion

• Single most likely diagnosis
  • Sinusitis: This is the most likely diagnosis given the symptoms of sinus congestion and facial numbness, which can be referred pain from the sinuses.
• Other Likely diagnoses
  • Migraine: Facial numbness can be a symptom of migraine, and sinus congestion can be a trigger or associated symptom.
  • Trigeminal Neuralgia: This condition causes sudden, severe facial pain, but can also cause numbness or tingling, and may be triggered by sinus pressure.
  • Dental issues: Dental problems such as an abscess or sinusitis related to a dental infection can cause facial numbness and sinus congestion.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Multiple Sclerosis: Although less likely, multiple sclerosis can cause facial numbness and should be considered, especially if other neurological symptoms are present.
  • Stroke or Transient Ischemic Attack (TIA): While rare in a 36-year-old, stroke or TIA can cause sudden facial numbness and should be ruled out immediately.
  • Cavernous Sinus Thrombosis: A rare but potentially life-threatening condition that can cause facial numbness, sinus congestion, and other neurological symptoms.
• Rare diagnoses
  • Sarcoidosis: A rare autoimmune disease that can cause sinus congestion and facial numbness due to granulomatous inflammation.
  • Lyme disease: A rare infectious disease that can cause facial numbness and other neurological symptoms, especially if left untreated.
  • Tolosa-Hunt syndrome: A rare condition that causes facial pain and numbness due to inflammation of the cavernous sinus or superior orbital fissure.