Differential Diagnosis for 23yo Male with Jaw Pain and Headache
- Single most likely diagnosis
- Migraine: The symptoms of throbbing pain behind the eyes and temples, preceded by jaw pain, are classic for migraine. Migraines can be triggered by various factors, including stress, certain foods, and even jaw tension.
- Other Likely diagnoses
- Tension headache: This is a common type of headache that can be caused by muscle tension in the neck and scalp, which could be related to the initial jaw pain.
- Temporomandibular joint (TMJ) disorder: Given the initial jaw pain, TMJ disorder is a plausible diagnosis, as it can cause pain in the jaw, face, and temples, and sometimes lead to headaches.
- Sinusitis: Although less likely without other symptoms like nasal congestion or fever, sinusitis can cause pain in the face, including the temples, and lead to headaches.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid hemorrhage: Although rare and less likely in a young patient without other risk factors, a sudden, severe headache (often described as "the worst headache of my life") could indicate a subarachnoid hemorrhage, which is a medical emergency.
- Temporal arteritis: This condition, more common in older adults, involves inflammation of the blood vessels in the temples and can cause severe headaches, jaw pain (especially when chewing), and visual disturbances. It's a medical emergency due to the risk of blindness.
- Acute angle-closure glaucoma: This is an eye emergency that can cause severe eye pain, headache, blurred vision, and sometimes nausea and vomiting. The pain can be referred to the temples.
- Rare diagnoses
- Cluster headache: These are extremely painful headaches that occur in cycles or clusters, often waking the patient from sleep, and are accompanied by autonomic symptoms like nasal congestion or eye watering on the same side as the headache.
- Trigeminal neuralgia: This condition involves sudden, severe, shock-like pain around the eyes, lips, or nose mainly because of abnormal blood vessels pressing on the trigeminal nerve in the head. It's less likely without the characteristic shock-like pain description.