Differential Diagnosis of Trigeminal Neuralgia
Single Most Likely Diagnosis
- Trigeminal neuralgia: This is the most likely diagnosis due to the characteristic symptoms of sudden, severe, and stabbing pain in the face, typically triggered by light touch or other innocuous stimuli.
Other Likely Diagnoses
- Dental problems (e.g., tooth abscess, cracked tooth): Dental issues can cause facial pain that may be mistaken for trigeminal neuralgia.
- Temporomandibular joint (TMJ) disorder: TMJ disorders can cause facial pain, jaw clicking, and limited jaw mobility, which may be confused with trigeminal neuralgia.
- Cluster headaches: These are severe headaches that occur in clusters or cycles, often accompanied by autonomic symptoms like nasal congestion and eye watering.
- Occipital neuralgia: This condition involves inflammation of the occipital nerves, leading to pain in the back and side of the head, which may radiate to the face.
Do Not Miss Diagnoses
- Multiple sclerosis: This condition can cause trigeminal neuralgia as a presenting symptom, and missing the diagnosis could lead to delayed treatment and worsening of the disease.
- Brain tumor (e.g., acoustic neuroma, meningioma): A tumor compressing the trigeminal nerve can cause symptoms of trigeminal neuralgia, and missing the diagnosis could lead to serious consequences, including increased intracranial pressure and neurological deficits.
- Stroke or transient ischemic attack (TIA): Although less common, stroke or TIA can cause sudden onset of facial pain, and missing the diagnosis could lead to delayed treatment and increased risk of further vascular events.
Rare Diagnoses
- Glossopharyngeal neuralgia: This is a rare condition characterized by severe pain in the throat, ear, and tongue, often triggered by swallowing or talking.
- Sphenopalatine neuralgia: This condition involves inflammation of the sphenopalatine ganglion, leading to facial pain, often accompanied by autonomic symptoms like nasal congestion and eye watering.
- Raeder's syndrome: This is a rare condition characterized by a combination of facial pain, ptosis, and miosis, often caused by a lesion in the middle cranial fossa.
- Trigeminal neuropathic pain: This is a rare condition characterized by chronic pain in the face, often caused by damage to the trigeminal nerve, which can be due to various factors, including trauma, infection, or surgery.