Orofacial pain bridges an important gap between medicine and dentistry. This article presents the case of a man who reported preauricular pain, tinnitus, and vertigo that began after extraction of an impacted third molar and who was sent for evaluation of a possible temporomandibular joint disorder. However, he was subsequently found to have markers and imaging results consistent with recurrent and more centralized lupus and/or multiple sclerosis. Keywords: lupus, multiple sclerosis, optic neuritis, temporomandibular disorders, tinnitus