Trigeminal Neve Activation After Covid or Vaccine:
Facial pain or numbness has been reported after either getting Covid or the mRNA vaccine.
Trigeminal Neuralgia:
Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve. This nerve transmits sensory information from the face to the brain.
There are three branches of the trigeminal nerve, each responsible for different areas of the face: the ophthalmic, maxillary, and mandibular branches.
The exact cause of trigeminal neuralgia is not completely understood, but it can be due to irritation or compression of the trigeminal nerve. One cause of compression can be from a blood vessel pushing on it.
When the trigeminal nerve is irritated or compressed, it can cause sudden, severe facial pain that lasts from a few seconds to several minutes. This pain is typically described as a sharp, stabbing, or electric shock-like sensation. It can be triggered by everyday activities, like eating, talking, brushing teeth, or even just touching the face. The pain may come and go, with periods of remission and flare-ups.
Trigeminal neuropathy:
Trigeminal neuropathy is a condition where the trigeminal nerve becomes damaged or impaired.
In contrast to trigeminal neuralgia, which is characterized by sudden, severe facial pain, trigeminal neuropathy typically presents with different symptoms. These can include:
- Facial pain: Although the pain associated with trigeminal neuropathy can sometimes resemble the sharp, stabbing pain of trigeminal neuralgia, it is generally more constant, dull, or aching in nature.
- Numbness or tingling in the face: People with trigeminal neuropathy may experience a loss of sensation or altered sensation in the areas served by the trigeminal nerve.
- Weakness in the jaw muscles: This can make it difficult to chew or may cause the jaw to deviate to one side when opened.
The causes of trigeminal neuropathy can also differ from those of trigeminal neuralgia. While trigeminal neuralgia is often caused by irritation or compression of the trigeminal nerve, trigeminal neuropathy can result from a variety of factors, such as:
- Infections or inflammation: Conditions like Lyme disease or multiple sclerosis can cause inflammation and damage to the trigeminal nerve.
- Trauma or injury: Accidents, surgery, or dental procedures can result in damage to the trigeminal nerve.
- Tumors: Lesions or growths in the brain or along the nerve can compress or damage the trigeminal nerve.
- Systemic diseases: Conditions like diabetes or sarcoidosis can cause nerve damage throughout the body, including the trigeminal nerve.
Trigeminal neuralgia in Covid-19:
Headache and neurological symptoms are common in covid. Loss of smell and taste, as well as brain fog and more significant neurologic issues, have been reported by many.
What about covid in the trigeminal nerve area?
A case study explained that sharp facial pain, subsequently diagnosed as trigeminal neuralgia, was the only major symptom of Covid-19 for a 65-year-old man. The case study explained that lancing pain in the nerve was provoked by lightly touching a certain spot on the scalp. The MRI showed that there wasn’t anything compressing the nerve. The trigeminal neuralgia resolved after Covid ran its course.[ref]
Trigeminal Neuralgia after mRNA vaccine:
Another case study explains that a woman developed trigeminal neuralgia with extreme face pain the day after vaccination. The pain was severe enough to visit the hospital. In addition to the shooting pain in the face and jaw, tooth pain also ensued. Dental x-rays showed no abscess, and antibiotics made the trigeminal neuralgia worse. The eventual resolution of the pain with a seven-day course of steroids.[ref]
Another case study explains the reaction with trigeminal neuralgia and cervical radiculitis, which started three hours post-vaccination (Pfizer). The healthcare worker had numbness, swelling, and pain over the left face and neck, which peaked about 16 hours after the vaccination and caused the left side of her face to eventually go numb. On the third day of symptoms, her face was numb along with her neck (C2 and C3 area). She was admitted to the hospital, had an MRI, and was treated with pregabalin. After seven days, most of the numbness disappeared, but she continued to have persistent neuropathic pain and some numbness at the six-week followup appointment.[ref]
Shingles in trigeminal nerve due to Covid:
A case study explained sixteen cases of shingles (herpes zoster) in the trigeminal nerve triggered by a covid infection. The herpes zoster virus causes chickenpox in kids and can lay dormant in the nerve until triggered. Stress or immune suppression can cause the reactivation of the virus, which inflames the nerve and causes skin irritation.[ref]
Trigeminal Neuropathy from Covid plus Shingles:
Another case study revealed a case of persistent trigeminal neuropathy following a covid infection triggering the reactivation of herpes zoster in all three branches of the trigeminal nerve.[ref]
Long-term nerve changes.
An interesting animal study injected spike protein so that it would go to the brain. There was an initial response mounted in the animals, but the researchers found that the neurological impairments happened much later — 45 days later in the mice. The researchers found that the immune system (complement 1) eventually caused synaptic pruning in the brain, resulting in the memory and cognitive impairment symptoms found in long covid.[ref] I’m not sure that this applies to the long-term neuropathy symptoms seen in trigeminal neuropathy post-vaccine.
References:
Molina‐Gil, Javier, et al. “Trigeminal Neuralgia as the Sole Neurological Manifestation of COVID‐19: A Case Report.” Headache, vol. 61, no. 3, Mar. 2021, pp. 560–62. PubMed Central, https://doi.org/10.1111/head.14075.
Narasimhalu, Kaavya, et al. “Trigeminal and Cervical Radiculitis after Tozinameran Vaccination against COVID-19.” BMJ Case Reports, vol. 14, no. 6, June 2021, p. e242344. PubMed Central, https://doi.org/10.1136/bcr-2021-242344.