Trigeminal neuralgia occurring after the third dose of Pfizer BioNTech COVID-19 vaccine. Complication or coincidence? An illustrative case report and literature review

Abstract

the coronavirus disease 2019 pandemic is an ongoing concern for medical care worldwide. since its emergence, multiple CoViD-19 vaccines have been designed, allowing for more effective control of the pandemic. CoViD-19 vaccines, like any other form of medical intervention, may cause adverse and unforeseen side effects, varying in frequency and severity. Determining a correlation between the occurring symptoms and the vaccination is often a challenging task, requiring multiple data sources and reported cases. so far, there have been multiple reports of trigeminal neuralgia developing after CoViD-19 vaccination. a 36-year-old woman was admitted to the emergency ward due to chronic pain attacks in the left side of her face. the pain appeared two months ago, on the day following the vaccination using the third dose of the pfizer Biontech CoViD-19 vaccine. at the neurology Department she was diagnosed with trigeminal neuralgia. Based on the lack of any obvious causes, relation to the vaccination, and other similar reports, we assumed that the trigeminal neuralgia was a complication of the vaccination. hospital treatment consisted of oxcarbazepine, dexamethasone and pregabalin. treatment was successful, with transient episodes of exacerbation. six months after the onset of the disorder the patient remains without pain. we believe that the presented case supports the possibility of trigeminal neuralgia occurring in relation to the pfizer Biontech CoViD-19 vaccine administration. additional reports may further contribute to establishing a certain link.

Association of Coronavirus Disease 2019 Vaccination with Facial-Related Neurological Disorders: A Nationwide Retrospective Cohort Study

“…Unlike facial palsy, trigeminal neuralgia has also been reported as a potential complication of COVID-19 vaccination in case reports. Multiple cases have been documented, including a 36-yearold woman who developed trigeminal neuralgia after receiving the Pfizer BioNTech vaccine [9]. Another case involved a teenage boy who experienced facial nerve paralysis and sensory loss in the trigeminal nerve distribution following the Pfizer-BioNTech vaccination [17].…”

“…Several studies have reported a temporal relationship between vaccination and the onset of facial palsy [6][7][8], and cases of trigeminal neuralgia [9,10] following COVID-19 vaccination. However, these studies are mainly case reports and series and have limitations.…”

Trigeminal neuralgia and COVID-19 vaccination or infection

“…In this interesting study there was no reference to the possibility of COVID-19 infection. Since the advent of COVID-19 pandemic, cases of TN associated with infection or vaccination against the SARS-Cov 2 virus have been reported and deserve attention [9][10][11][12][13][14][15][16] .…”

“…Chrostowski K, et al reported a 36-year-old female with episodes of facial pain manifested two months ago, since the next day after the third vaccine for COVID-19 9 . She then successfully underwent oxcarbazepine, dexamethasone and pregabalin, and persists without pain episodes for six months after the onset of neurological disorder 9 .…”