Vaccination against SARS-CoV-2 has been instrumental in controlling the pandemic. After billions of doses administered, mRNA vaccines are demonstrably considered to be safe and effective. However, there have been documented reports of post vaccination neuropathies of various kinds, including trigeminal. Trigeminal neuralgia is defined as recurrent, unilateral, brief, electric shock like pain episodes in the trigeminal distribution that have an abrupt onset and termination. Epidemiologically it is more prevalent in women. It can be extremely debilitating and disruptive to daily activities. Here we present a case series of five women of South Asian origin, between the ages of 40-60 years who were seen at a family medical clinic in Greater Toronto Area between October 2021 and December 2021. These patients presented with complaints of facial pain that developed between 2-26 weeks post COVID-19 mRNA vaccination. Their symptoms were transient and marked by paroxysmal pain in the trigeminal territory. Detailed history was extracted, and pertinent investigations were done to rule out other potential causes of such pain, to arrive at a clinical diagnosis of idiopathic trigeminal neuralgia. Four out of five subjects showed significant improvement with a short course of oral gabapentin. On subsequent follow ups, all of them reported near resolution of symptoms.

Our findings suggest a possible correlation between trigeminal neuralgia and mRNA vaccines. Further research is required to confirm and understand the causal relationship between the vaccine administration and incidence of neuropathies. However, as it appears to be self-limiting, these presentations do not outweigh the benefits of COVID-19 mRNA vaccines.

Keywords – trigeminal neuralgia, COVID-19 mRNA vaccine, facial pain

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