Surgery may cure some cases of migraine

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Surgery to remove so-called trigger points for migraines can lead to dramatic improvements in patients’ health, researchers from University Hospitals in Cleveland reported today at a Seattle meeting of the American Society of Plastic Surgeons. Although surgery may seem like a drastic solution for what some people consider simple headaches, migraines are a major, debilitating problem for those who suffer them. They can produce severe pain and sensitivity to light and noise, sometimes restricting a patient to bed for a day or longer and dramatically interfering with their ability to function normally. Migraines can sometimes be prevented or mitigated with prophylactic drugs, and a relatively new family of drugs called triptans can reverse symptoms for many people. Surgery could be a last resort for those who can’t find relief through other treatments.

Dr. Bahman Guyuron, chairman of plastic surgery at University Hospitals Case Medical Center, and his colleagues performed surgery on 79 migraine sufferers, who were then followed for at least five years. Ten of the patients required additional surgeries and were removed from the analysis. Sixty-one of the remaining 69 patients maintained their positive response to the procedure for the full five years. Twenty patients reported elimination of the migraines entirely, 41 reported a significant decrease in symptoms and frequency, and eight experienced less than a 50% improvement.

For patients with frontal migraines, Guyuron removes the corrugator supercilii (frowning) muscle group in the forehead, which is thought to compress nerves and produce inflammation. For temple migraines, he removes a small branch of the trigeminal nerve. For headaches that are located behind the eye and triggered by weather changes, he works on the nose septum and surrounding structures. Guyuron said he had performed more than 1,000 procedures on more than 450 patients total.

-- Thomas H. Maugh II