Abstract text (incl. figure legends and references)

Introduction

Melkersson-Rosenthal syndrome (MRS) is a disease characterized by recurrent peripheral facial paralysis, orofacial edema and fissured tongue triad. Cranial neuropathies have also been reported after COVID vaccines. Here, we present a 53-year-old female patient with this rare syndrome who had new-onset trigeminal neuralgia after COVID vaccination.

Case Report

53-year-old female patient presented with itchy, burning like pain over the right mandibular region of her face for ten days. Pain was occurring as 10-20 attacks per day lasting seconds. She reported that the new onset pain had started 2 days after the mRNA COVID vaccine. Concerning her medical history, she was diagnosed with MRS which had three previous episodes of peripheral facial paralysis and recurrent orofacial edema. Cranial imaging, serum and cerebrospinal fluid analysis were normal. She was diagnosed as trigeminal neuralgia (TN) and symptomatic treatment with gabapentin 1200 mg/day had started. She was pain-free for the past month.

Discussion

Cranial nerve involvement in MRS can be seen and the facial nerve is the most commonly involved one. Rarely, other cranial nerves may also be affected with complaints of impaired taste and hearing or trigeminal neuralgia. Cranial neuropathies have also been reported after COVID vaccines, and there are a few cases of post-vaccination trigeminal neuralgia in the current literature. The time interval between vaccination and TN in the reported cases was approximately 7-14 days. However, in our case, the onset of TN was quite rapid, and we interpreted this situation as the combination of MRS and COVID vaccine may facilitate the onset of TN.

References

1- Kaya A, Kaya SY. A case of trigeminal neuralgia developing after a COVID-19 vaccination. J Neurovirol. 2022 Feb;28(1):181-182. doi: 10.1007/s13365-021-01030-7. Epub 2021 Dec 6. PMID: 34870807; PMCID: PMC8647511.