Facial Pain: Or something else? Differential Diagnosis

Respiratory System (J00-J99)

Eyes and eye appendages (H00-H59).

  • Acute inflammation of the eye, unspecified.
  • Acute glaucoma (green star)
  • Iritis (inflammation of the iris)
  • Optic neuritis (neuritis nervi optici; optic neuritis).
  • Tolosa-Hunt syndrome (synonym: ophthalmoplegia dolorosa, painful ophthalmoplegia) – severe pain behind the eye; on the same side, moreover, paralysis of the eye muscles supplied by the oculomotor nerve, trochlear nerve and abducens nerve.

Infectious and parasitic diseases (A00-B99).

  • Herpes zoster (shingles)
  • Mumps
  • Syphilis (Lues)

Mouth, esophagus (esophagus), stomach, and intestines (K00-K67; K90-K93).

  • Dental abscess – encapsulated collection of pus in the area of the tooth.
  • Osteitis mandibularis/ -maxillaris – bone inflammation in the area of upper/lower jaw.
  • Parotitis (parotid gland inflammation) – due to abscess or obstruction of the excretory duct.

Musculoskeletal system and connective tissue (M00-M99).

  • Arteritis temporalis – systemic vasculitis (vascular inflammation) affecting the arteriae temporales (temporal arteries), especially in the elderly.
  • Temporomandibular joint dysfunction (temporomandibular joint dysfunction).
  • Myoarthropathies (muscle-joint diseases) of the temporomandibular joint.
  • Upper spondylosis cervicalis (spondylosis: collective term for degenerative changes in vertebral bodies (and intervertebral spaces; cervicalis: “in the area of the cervical spine”).
  • Ostitis (inflammation of bone tissue) mandibularis (“belonging to the lower jaw“) or maxillaris (“belonging to the upper jaw“).
  • Retropharyngeal tendinitis (belongs to the dystrophic tendon calcifications).

Neoplasms – tumor diseases (C00-D48).

  • Malignant neoplasms of the posterior fossa and orbit (eye socket).
  • Nasopharyngeal carcinoma – malignant neoplasm of the nasopharyngeal region.
  • Tongue carcinoma – malignant neoplasm of the tongue.

Psyche – nervous system (F00-F99; G00-G99)

  • Persistent idiopathic facial pain (definition: see below Facial pain/causes).
  • Atypical facial pain – belongs to the group of primary facial pain (primary without an identifiable cause); occurrence of pain in the area of the face, and thus in the area of the trigeminal nerve, but not strictly seizure-like (paroxysmal).
  • Cluster headache* – typically perceived as a combined headache and facial pain.
  • Chronic paroxysmal hemicrania (CPH) (paroxysmal “seizure-like”; hemicrania “half-head (/skull) pain“).
  • Depression (may be related to atypical facial pain).
  • Diabetic ocular neuropathy
  • Glossopharyngeal neuralgia – belongs to the group of primary facial pain; neuralgia (nerve pain) that can occur due to partial attack pain in the hypopharynx (lowest part of the pharynx), base of the tongue, tonsils (tonsils) and ear region with appropriate irritation, e.g., chewing, swallowing, speaking (very rare!)
  • Meningitis (meningitis)
  • Migraine* – here: pure facial pain (probably special form of migraine).
  • Multiple sclerosis (MS)
  • N.-intermedius neuralgia (synonym: geniculate neuralgia) – pain disease from the group of facial diseases; typical feature are strictly unilateral, pain attacks in the area of the external auditory canal.
  • N. laryngeus neuralgia
  • Nasociliary nerve neuralgia – belongs to the group of facial pain; unilateral pain in the inner corner of the eye, radiating to the orbit and bridge of the nose.
  • Occipital neuralgia (called occipital pain; it involves pain in the back of the head) – typically shooting in (lancinating) pain and the supply area of the greater occipital nerve.
  • Optic neuritis (optic neuritis).
  • Paroxysmal hemicrania (paroxysmal “seizure-like”; hemicrania “half-head (/skull) pain”).
  • Raeder syndrome (synonym: paratrigeminal syndrome) – paratrigeminal neuralgia (nerve pain) or paratrigeminal paralysis (paralysis) of the sympathetic nervous system; due todamage to the internal carotid artery (eg.B. due to a dissection/splitting of the wall layers of an artery) or lesion (e.g., space-occupying lesion) in the middle cranial fossa.
  • Tension headache*
  • SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing; short-lasting unilateral neuralgiform headache with conjunctival redness and tearing).
  • Supraorbital neuralgia – neuralgia (nerve pain) in the supraorbital branch of the trigeminal nerve.
  • Trigeminal neuralgia – severe pain originating in the fifth cranial nerve (trigeminal nerve), which supplies mainly the facial skin.
  • Trigeminoautonomic headache (TAK).
  • Central neuralgia (“nerve pain”).

* Migraine, tension-type headache, and cluster headache may present as pure facial pain (“facial migraine“). Injuries, poisonings, and other sequelae of external causes (S00-T98).

  • Injuries to the face, unspecified