Differential Diagnosis for Burning Right Ear, Posterior Head Pain, and Radiating Right Face Pain

• Single Most Likely Diagnosis
  • Trigeminal Neuralgia: This condition is characterized by sudden, severe, and stabbing pain typically around the eyes, lips, or nose due to irritation of the trigeminal nerve. The pain can radiate to the face and is often triggered by light touch. Given the description of burning pain radiating into the right face, trigeminal neuralgia is a plausible diagnosis.
• Other Likely Diagnoses
  • Occipital Neuralgia: Involves inflammation or irritation of the occipital nerves, leading to pain in the back and top of the head, which can radiate to the face. The symptoms can include a burning or throbbing sensation, making it a possible diagnosis for the described pain.
  • Temporomandibular Joint (TMJ) Disorder: TMJ disorders can cause pain in the jaw, face, and head, including the area around the ear. The pain can be sharp and burning, especially when moving the jaw.
  • Migraine: Although typically associated with headache, migraines can cause a variety of neurological symptoms, including pain that can be localized to one side of the head and face, potentially involving the ear and posterior head.
• Do Not Miss Diagnoses
  • Stroke or Transient Ischemic Attack (TIA): While less common, stroke or TIA can present with sudden onset of facial pain or numbness, among other neurological deficits. It's crucial to rule out these conditions due to their high morbidity and mortality.
  • Multiple Sclerosis: An autoimmune disease that affects the brain and spinal cord, leading to a wide range of neurological symptoms, including pain, numbness, and tingling in the face.
  • Giant Cell Arteritis: An inflammation of the arteries in the head, which can cause severe headaches, facial pain, and visual disturbances. It's a medical emergency if vision is threatened.
• Rare Diagnoses
  • Raeder’s Syndrome: A rare condition characterized by a combination of facial pain (often described as burning), ptosis (drooping eyelid), and miosis (constricted pupil) on the same side, typically without other neurological deficits.
  • Glossopharyngeal Neuralgia: Involves the glossopharyngeal nerve and can cause sharp, stabbing, or burning pain in the back of the throat, tongue, and ear, which is less common than trigeminal neuralgia but should be considered in the differential diagnosis for facial pain.
  • Petrous Apicitis: A rare but serious infection of the petrous part of the temporal bone, which can cause severe pain in the face and head, including the ear, along with other neurological symptoms.