Surgery for Migraines?

Anyone who has had a migraine headache can tell you how horrible they are. While some people have only severe pain, others may be sensitive to light or sound, may be nauseated and vomit, or even have difficulty seeing.

Migraine medications have come a long way over the past 10 or 20 years, but for some people, they still don’t help. For those, other treatments must be found. A new study has found that surgery may be the solution for some migraineurs. Researchers studied 79 people who experienced migraines who had undergone surgery treating their trigger sites. The patients were followed for five years after their surgery and 69 were included in the final study results because 10 had developed new trigger sites that required another surgery.

The results showed:

• 88% reported good results that stayed for the full five years
• 29% reported that their migraines disappeared completely and stayed away
• 59% reported that their migraines had decreased significantly
• 11% said that they had less than a 50% improvement or no change in their migraines

Lead author, Bahman Guyuron, MD, Chairman of Plastic Surgery at University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, has performed more than 1000 surgeries for these trigger sites on 450 patients (there are an average of 2.5 trigger points per person). The different types of headaches require surgery on different areas.

Frontal migraines: For people who have migraines in the front of the head, Dr. Guyuron may remove some of the muscle in the forehead responsible for frowning.

Temple migraines: If the migraines are on the side of the head, removing a small point of the trigeminal nerve on the side may help relieve migraine pain.

Occipital (back of the head) migraines: These may respond from removal a bit of muscle in the back of the head that surrounds a nerve that may cause migraines.

Behind the eye: These migraines may be triggered by changes in the weather. Dr. Guyuron treats these by operating on the nose septum and surrounding area.

The results of the most recent study were presented yesterday, October 24, 2009, at the American Society of Plastic Surgeons annual meeting.

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