Treatment of COVID-19 Vaccine-triggered Migraine
A 55-year-old woman with a long history of chronic migraines saw her symptoms worsen after getting a COVID-19 mRNA vaccine. Normally, her migraines were manageable with topiramate and sertraline. Despite medication adjustments, her pain escalated, scoring a 9 on the Visual Analogue Scale (VAS). The underlying mechanisms of how SARS-CoV-2 impacts the nervous system remain unclear. Research suggests that the virus can invade the nervous system and trigger headaches by causing inflammation and vascular changes. Headache and loss of smell (anosmia) are thought to be linked to this direct neural invasion. Calcitonin gene-related peptide (CGRP) is key in migraine pathophysiology, involved in pain transmission and inflammation. Elevated levels of interleukin (IL)-6 and tumor necrosis factor alpha (TNF-a), common in COVID-19, also increase CGRP, influencing symptoms like cough, fever, and pain. Studies have found structural similarities between CGRP receptors and SARS-CoV-2 spike proteins, sug...