Patient with recurrent pain over right cheek that increases on chewing and between attacks patient is otherwise normal. Most probable diagnosis is?
**Core Concept**
The patient's symptoms of recurrent pain over the right cheek that increases on chewing suggest a condition involving the trigeminal nerve, specifically the mandibular division. This is a classic presentation of trigeminal neuralgia or a related entity.
**Why the Correct Answer is Right**
The correct answer is likely **Trigeminal Neuralgia (TN)**. TN is a chronic pain condition characterized by sudden, severe, and brief episodes of pain in the face, often triggered by chewing, talking, or other facial movements. The pain is usually unilateral and affects the mandibular division of the trigeminal nerve (V3). The condition is often idiopathic, but it can be caused by compression of the nerve by a blood vessel, tumor, or other lesion.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because it does not accurately describe the patient's symptoms. While pain in the face can be a symptom of many conditions, the specific pattern of pain described (increasing with chewing) is more characteristic of trigeminal neuralgia.
* **Option B:** This option is incorrect because it is not a common cause of recurrent pain in the face. While dental problems can cause pain, the patient's symptoms are not typical of a dental issue.
* **Option C:** This option is incorrect because it is not a specific diagnosis that matches the patient's symptoms. While facial pain can be a symptom of many conditions, this option is too vague to be a correct answer.
* **Option D:** This option is incorrect because it is not a common cause of recurrent pain in the face. While migraines can cause facial pain, the patient's symptoms are not typical of a migraine.
**Clinical Pearl / High-Yield Fact**
Trigeminal neuralgia is often associated with multiple sclerosis (MS), and patients with MS are more likely to develop TN. In fact, up to 4% of patients with MS may develop TN.
**Correct Answer:** C. Temporomandibular joint disorder