Trigeminal neuralgia as the sole neurological manifestation of COVID‐19: A case report

Abstract

In December 2019, the first cases of atypical pneumonia caused by a new pathogen, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), were detected in Wuhan, China. In March 2020, the World Health Organization declared coronavirus disease-2019 (COVID-19) as a pandemic. 1,2 Manifestations within the respiratory system are dominant in COVID-19. However, other manifestations such as headache, abdominal pain, diarrhea, and loss of taste and smell have been added to the clinical spectrum during the course of the disease, 1,2 and numerous case series and reviews have been published on the neurological manifestations, highlighting the potential neurotropism of the new coronavirus. 3-5 Approximately 40% of patients with COVID-19 have presented with neurological symptoms. 3,4 Headache was reported in 11%-34% of the hospitalized patients, but few studies have carried out a characterization of pain. 5 An observational Spanish study described 112 health professionals who suffered headache during COVID-19. The authors found that headache appeared on the fourth day from the beginning of

Persistent Symptoms in Post-COVID-19 Patients Attending Follow-Up OPD at Sukraraj Tropical and Infectious Disease Hospital (STIDH), Kathmandu, Nepal

“…Similarly, another patient reported a new onset of burning sensation and lancating pain at the left perinostrillar and maxillary area eight weeks following recovery from mild COVID-19 infection, suggestive of left-sided trigeminal neuralgia. The existence of trigeminal neuralgia in relation to SARS-CoV-2 has been recently described in the literature as one of the uncommon manifestations of COVID-19 [16]. Two (1.7%) patients complained of impaired concentration following COVID-19, of which one was below 30 years of age who did not require hospital admission and the other was above 75 years of age, treated in an intensive care unit.…”

The neuroinvasiveness, neurotropism, and neurovirulence of SARS-CoV-2

“…Whether SARS-CoV-2 is transported to the CNS transaxonally in OSNs or through diffusion via channels formed by olfactory ensheathing cells along the olfactory nerve remains unclear. CNS invasion via the trigeminal nerve has been suggested in humans, as viral RNA has been detected in the trigeminal ganglion, suggesting virus spread via nerve endings to the soma of sensory neurons [16,[21][22][23][24]. Evidence in humans for virus invasion through the vagus nerve has been provided by the detection of SARS-CoV-2 proteins by immunohistochemistry in vagus nerve fibers [23,25].…”

Chronic Pain in the Elderly: Mechanisms and Perspectives

“…At this moment, it is imperative to consider COVID-19 pandemic as a relevant factor for painful complications in elders. An interesting case report described the occurrence of trigeminal neuralgia affecting the ophthalmic nerve division, in a 65-year-old man presenting with respiratory symptoms of SARS-CoV-2 infection, which has been solved after patient recovery ( Molina-Gil et al, 2021 ). The most relevant question in this respect is whether elders that had been infected with the virus might present persistent painful alterations following recuperation.…”