Treatment of COVID-19 vaccine resistant migraine attack with CGRP monoclonal antibody: a case report

Abstract

Many researches have shown that coronavirus infection can lead to neurological symptoms. The most common symptom is headache. Calcitonin gene-related peptide (CGRP), which has an important role in the pathophysiology of migraine, may have an active role in persistent headaches after COVID, due to the structural similarity between the CGRP receptor and the SARS-CoV-2 spike protein. In this case report, the effect of the anti-CGRP monoclonal antibody on the migraine attack occurring after COVID-19 m-RNA vaccine will be discussed. A 55-year-old female patient who is followed up with a diagnosis of chronic migraine, had severe and throbbing headache that started after the COVID-19 m-RNA vaccine. After galcanezumab (CGRP monoclonal antibody - CGRP mAb) was started in the patient whose complaints did not regress despite the adjustment of the current drug doses, clinically significant improvement was observed in her complaints after the first dose and it was planned to continue with 120 mg CGRP mAb per month in her follow-ups.