A Case of Lingual Neuropathic Pain in the Post COVID-19 Condition

Abstract

  We report a case of lingual neuropathic pain in the post coronavirus disease 2019 (COVID-19) condition. The pain disappeared after mirogabalin (MGB) treatment.

  The patient was a 17-year-old female who complained of a burning pain on her tongue. Approximately 80 days before her initial visit, she tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) and was diagnosed with COVID-19. The morbidity of COVID-19 symptoms was mild. However, the burning pain on her tongue remained after she tested negative for SARS-COV-2. The pain was a persistent burning pain that worsened with eating and talking. On examination, she had marked allodynia on her tongue. The examination results ruled out post-traumatic trigeminal neuropathic pain, burning mouth syndrome, endocrine disorders, oral candidiasis, xerostomia, and zinc or vitamin deficiency. The patient met the World Health Organization criteria for the post COVID-19 condition ; therefore, we diagnosed lingual neuropathic pain in the post COVID-19 condition and started treatment with MGB. After 14 days, the persistent pain decreased. MGB was gradually increased to 20 mg/day. After approximately 3 months, the persistent pain disappeared, and dysesthesia only occurred after eating and talking. MGB was thereafter gradually decreased. Finally, she took 5-10 mg/day only when she became aware of dysesthesia due to factors such as fatigue and stress. However, her initial complaints of persistent pain on the tongue that worsened with eating and talking have disappeared.

  In the diagnosis of neuropathic pain in the trigeminal region, the possibility that SARS-CoV-2 infection is the cause should be considered.