Trigeminal neuralgia and COVID-19 vaccination or infection

Ano: 2024 | Volume: 62 | Número: Não se aplica

Autores: Vitorino Modesto dos Santos, Taciana Arruda Modesto Sugai

Palavras-chave: COVID-19, TRIGEMINAL NEURALGIA, VACCINATION, INFECTIONS

Resumo Inglês:

Trigeminal neuralgia (TN) is an infrequent condition manifested by excruciating unilateral electric shock-like facial pain, with classical abrupt onset and termination 1-8. TN may be idiopathic, but the etiological factors include vascular nerve compression (classic TN), multiple sclerosis, tumor, trauma, herpes zoster, and temporomandibular dysfunction (secondary TN); arterial hypertension and diabetes are comorbidities 1,2,5,8. The pains may start by eating, drinking, talking, touching the face, or a puff of wind 2 . The estimated prevalence is up to 13% yearly,1 occurring more often among females between from 50 to 70 years of age, and mainly affecting the second or third branches 1,2. The intensity and persistence of painful episodes cause deleterious effects on the work activities and quality of life of the patients, mainly those presenting refractory pain 1-5. Consistent literature data have confirmed the high efficacy and tolerability of utilizing gabapentin and other α2δ ligands to control patients with this excruciating pain, carbamazepine and oxcarbazepine are also recommended to first-line pharmacotherapy; additional procedures can include nerve blocks, surgery, or radiofrequency ablation 1-8. Alvarado Bardales, et al. reviewed the findings of 61 patients with TN in Mexico during the year of 2019; 62.3% were females, the mean age was 60.2 ± 16.8 years, the involved sites were left branch combinations (36.1%), right branch (27.9%), and right maxillary branch (13.1%) 1 . The cornerstone resources for the management of pain during hospital stay was utilizing carbamazepine as gold standard, and gabapentinoids, opioids, and tricyclic or dual-action antidepressants; eight patients underwent some nonpharmacological intervention aiming obtain the best of pain control. With pre-admission use of NSAIDS the pain was severe (96.7%) or moderate; the treatment with carbamazepine (86.8%) and gabapentinoids (60.6%) resulted in the discharges without pain (24.6%), mild pain (57.4%), moderate pain (13.1%), and severe pain (4.9%). The authors commented on the necessity of non-pharmacological intervention utilized for eight of the patients who did not obtain the pain control with solely the drug schedules 1 . 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