Session Information
Session Title: AA 2022 Posters - Neurological Rehabilitation
Session Time: None. Available on demand.
Disclosures: Neyha Cherin: No financial relationships or conflicts of interest
Case Diagnosis: A 37-year-old woman with daily headaches after Johnson & Johnson (J&J) COVID-19 vaccine.
Case Description or Program Description: A patient with 10 months of daily headaches notes an inability to care for her son and complete daily tasks. Headaches started immediately after receiving the J&J COVID-19 vaccination. Headaches are burning, aching, throbbing, and begin occipitally “creeping” bilaterally over the scalp. The patient has no past medical history including headaches or migraines. Over 10 months, she has seen multiple specialties. Initial differential included atypical migraine, immune reaction post-vaccine with possible underlying Lyme disease activation, and atypical shingles. Therapy, chiropractic services, and multiple pharmacological treatments offered no relief. Imaging of the brain and neck was normal.
Setting: Physical Medicine and Rehabilitation (PM&R) clinic.
Assessment/Results: Upon evaluation in PM&R, palpation of bilateral greater occipital nerves reproduced symptoms. Based on this chronic bilateral occipital neuralgia was diagnosed. Bilateral greater occipital nerve blocks were offered for diagnostic confirmation and therapeutic relief. To ensure relaxation of the neck musculature therapeutic exercises were provided.
Discussion (relevance): Neurological side effects after J&J COVID-19 vaccine are reported including Guillain-Barré syndrome, Bell’s Palsy, and cerebral venous sinus thrombosis. 1 Additionally, mild neurological events such as headache, anxiety-related syncope, and dizziness are frequently reported after vaccination. Each of these cases is characterized as acute, and symptoms tend to resolve within a month.1 To our knowledge, this is the first reported case of chronic bilateral occipital neuralgia developing following a standard dose of the J&J COVID-19 vaccine.
Conclusions: These findings suggest chronic bilateral occipital neuralgia is a potential side effect of the J&J COVID-19 vaccine. It is necessary to consider bilateral occipital neuralgia on the differential for headache following vaccination, as chronic pain can impair a patient’s ability to perform activities of daily living.
Level of Evidence: Level IV
To cite this abstract in AMA style:
Cherin N, Milne I, Fye NM. Chronic Bilateral Occipital Neuralgia After the Johnson & Johnson COVID-19 Vaccination: A Case Report [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/chronic-bilateral-occipital-neuralgia-after-the-johnson-johnson-covid-19-vaccination-a-case-report/. Accessed May 11, 2025.« Back to AAPM&R Annual Assembly 2022
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/chronic-bilateral-occipital-neuralgia-after-the-johnson-johnson-covid-19-vaccination-a-case-report/