Retrogasserian Glycerol Rhizotomy (RGGR) for Trigeminal Neuralgia Induced by Postvaccination Herpetic Reactivation: A Rare Case Report.

Reports on surgical treatment for postherpetic trigeminal neuralgia after COVID vaccination have not been found in the literature. Here, we described a case of postherpetic trigeminal neuralgia after COVID vaccination that was treated with percutaneous retrogasserian glycerol rhizotomy (PRGR) resulting in complete pain relief. We reported a case involving a 70-year-old female who had herpes zoster infection in the ophthalmic branch (V1) dermatome following COVID vaccination and presented with paroxysmal electric shock-like sensation without a trigger. Her pain was refractory to medical management. Her Barrow Neurological Institute pain intensity score was IV. Magnetic resonance imaging of the brain was normal. PRGR was performed. The patient's pain decreased over the next 2 h, and she was pain-free from post-procedure Day 2 while taking carbamazepine 400 mg/day, which was tapered over 2 weeks. At her 3-month follow-up, the patient was reviewed and remained pain-free. Percutaneous treatment of postherpetic trigeminal neuralgia may be considered the treatment of choice in vaccination-induced postherpetic trigeminal neuralgia.