Treatment of SMg is challenging and lacks international consensus. Though the pathophysiology of SMg is largely unknown, some risk factors including psychiatric comorbidities (i.e., depression and anxiety) and daily-life stressors have been identified. SMg can be a very debilitating condition, precluding the normal daily activities of the affected individual and, in some cases, leading to systemic manifestation such as severe dehydration and electrolyte imbalance in case of associated nausea and vomiting. In most cases, headache can be moderate-severe in intensity and last few days, generally resolving spontaneously or responding to common analgesic medications.Īccording to International Classification of Headache Disorders (ICHD-3), status migrainosus (SMg) is a severe condition characterized by migraine attacks, moderate-severe in intensity, lasting for more than 72 h. In the population vaccinated with Comirnaty (Pfizer/BioNtech) vaccine, both migraine and tension-type headaches have been described. Neurological adverse effects have been described in several cases and may include sleeping disorders, dizziness, paresthesia, and headache.Īccording to literature, headache is one of the most frequent side effects due to coronavirus disease-19 (COVID-19) vaccines. Although their undeniable efficacy, vaccines have also been related to several side effects which can be limited to the injection site (e.g., pain, redness, swelling) or presenting as systemic manifestations (e.g., fever, chills, tiredness). In the countries with the highest rate of vaccination, there has been a clear reduction in the spread of the virus and consequently a reduction in the number of deaths and hospitalized patients. Since the first mass vaccination program started in early December 2020, about 31.6% of the worldwide population has completed the vaccination cycle and more than 5.5 billion doses of vaccine have been administered (updated to September 2021). This may be related to the inflammatory response that occurs after vaccination. In patients with a history of migraine, COVID-19 vaccination could lead to a worsening of headache and, in rare cases, to the development of a SMg. In the present report, we describe a case of SMg that lasted 11 days, time correlated with the second dose of COVID-19 vaccine (Pfizer/Comirnaty) in a 37-year-old woman with a history of migraine without aura. Symptoms of SMg can be very severe, preventing the normal daily activities of the individual. According to ICHD-3 Classification, status migrainosus (SMg) is described as a debilitating migraine attack lasting for more than 72 h. Although vaccines have an undeniable efficacy, they can also present several neurological side effects, including headache. Comirnaty (Pfizer/BioNtech) COVID-19 vaccine is a lipid nanoparticle-formulated, nucleoside mRNA vaccine encoding the prefusion spike glycoprotein of SARS-CoV-2. During the last months, different types of vaccines have been designed to contain the ongoing SARS-CoV-2 pandemic, with successful results in many countries. Coronavirus disease-19 (COVID-19) due to acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is the largest emergency that humanity had to be dealing with in the last century.
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