Cosmetic Surgery Provides Significant Migraine Relief

A new study shows that a non-endoscopic approach to migraine treatment could be useful for surgeons with little experience, as well as in patients with challenging anatomy.

Researchers at Louisiana State University (LSU; Baton Rouge, USA) and Harvard Medical School (Boston, MA, USA) conducted a study in 35 patients who suffered from chronic nerve compression migraine headaches, confirmed by previous positive response to Botox or nerve block treatments. The patients underwent 43 trigger deactivation procedures via non-endoscopic plastic surgery techniques. Pre- and 12-month post-operative questionnaires and patient charts were reviewed, and response to surgery in terms of migraine symptom relief and adverse events were evaluated.

The procedure is based on the theory that migraine headaches arise due to inflammation of trigeminal nerve branches in the head and neck caused by irritation of the surrounding musculature, bony foramen, and perhaps fascia bands. Accordingly, surgical treatment of the migraines involves removing the relevant tissues, following clinical evaluation and diagnostic injections of botulinum toxin to locate the trigger sites. The specific surgical procedure varies according to the individual’s migraine trigger site.

The results showed an overall positive response rate of 90.7%. Migraine headaches were totally eliminated in 51.3% of the patients, with about a fifth of them experiencing an 80% reduction of symptoms; 28.2% had resolution between 50%–80%. No significant effect was reported following 9.3% of the procedures. There were no major adverse events reported. The study was published ahead of print on June 16, 2014, in Plastic and Reconstructive Surgery.

“Surgery is a valid treatment for migraines in certain patients. We believe that these patients should have ready access to migraine trigger site decompression surgery,” said study coauthor Assistant Professor of clinical surgery Oren Tessler, MD, of the LSU Health Sciences Center, and colleagues. “Although larger studies are needed, we have shown that we can restore these patients to full and productive lives.”

Migraine is a debilitating condition characterized by moderate to severe headaches, and is three times more common in women than in men. The typical migraine headache is unilateral pain and pulsating in nature, lasting from 4 to 72 hours; symptoms include nausea, vomiting, photophobia (increased sensitivity to light), phonophobia (increased sensitivity to sound), and is aggravated by routine activity. Approximately one-third of people who suffer from migraine headaches perceive an aura—unusual visual, olfactory, or other sensory experiences that are a sign that the migraine will soon occur.

Related Links:
Louisiana State University
Harvard Medical School