Sex: F
Vaccine: COVID19
Symptoms: Visual impairment
Clinical narrative: neuropathic pain; transient vision problems in her right eye; headache; diffuse myalgia; fever; burning pain; elevated erythrocyte sedimentation rate; This spontaneous report received from a health care professional. This report was referenced in literature. The patient's height and weight were not reported. Age at time of vaccination was unknown.  No past medical history, concurrent conditions or pre-existing medical conditions were reported.  The patient received janssen covid-19 vaccine (suspension for injection, route of admin not reported, batch number not reported) dose, frequency and therapy dates not reported, additional dosage information included: dose series 1, for covid-19 prophylaxis. The batch number was not reported and has been requested.  No concomitant medications were reported.  On an unspecified date, the patient experienced neuropathic pain, transient vision problems in her right eye, headache, diffuse myalgia, fever, burning pain, and elevated erythrocyte sedimentation rate. (dose series 1) The  patient developed a persistent pressure like headache accompanied by burning pain from the top of her scalp to her fingertips. Patient was started on  prednisone by  her primary care physician which helped some, but  the headache never resolved completely. She had 3 emergency room visits for headache with negative imaging for intracranial pathology. She  also reported transient vision problems in  her  right eye,  which along with elevated erythrocyte sedimentation rate  and  C- reactive protein, prompted a rheumatology referral for concern of giant cell arteritis. She was started on Topiramate, Amitriptyline, and  Pregabalin by  her primary care physician. Her rheumatologic lab workup was negative. Patient was referred to us for management of nonspecific pain symptoms. On  her initial evaluation, she  reported diffuse burning like sensations with no specific dermatomal distribution. She also expressed diffuse aching muscle pain. Physical exam did not show sensory deficits or weakness. There was tenderness to palpation over the paraspinal muscles, and she was offered trigger point injections (TPIs). TPIs offered brief (1-2weeks) improvement in her pain, however after 2 years of treatment, the patient was unsatisfied with the temporary relief from TPIs. The patient requested a different direction in her  pain management. The patient's prescriptions were adjusted and low-dose naltrexone was started. Over time, the patient's medications were adjusted until a  balance of adequate analgesia and fatigue were achieved. Her regimen consisted of  topiramate 50 mg  twice a day, pregabalin 100mg in the morning and at noon (dosing per patient's preference, due  to  fatigue in the  afternoon), baclofen20mg  3 times per day, and low-dose naltrexone 4.5mg once a day. She also expressed pain psychology therapy to bebeneficial. The action taken with janssen covid-19 vaccine was not applicable.  The outcome of neuropathic pain, transient vision problems in her right eye, diffuse myalgia, burning pain and elevated erythrocyte sedimentation rate was not reported. The patient had not recovered from headache. The patient recovered from fever on an unspecified date.  This report was serious (other medically important condition).; Sender's Comments: V0:  Neuralgia : The event(s) has an unknown/unclear temporal relationship, is unlabeled, and is scientifically plausible. There is no information on any other factors potentially associated with the event(s). Therefore, this event(s) is considered unassessable