Study confirms benefit of surgical treatment for migraines

Dr. Oren Tessler, Assistant Professor of Clinical Surgery at LSU Health Sciences Center New Orleans School of Medicine, is part of a team of plastic and reconstructive surgeons who report a high success rate using a method to screen and select patients for a specific surgical migraine treatment technique. More than 90% of the patients who underwent this surgery to decompress the nerves that trigger migraines experienced relief and also got a bonus cosmetic eyelid surgery. The study, which confirms the benefit of surgical treatment for migraines and expands access to it, is published online ahead of print in the journal, Plastic and Reconstructive Surgery.

The technique offers an alternative to the commonly used endoscopic approach which works down from the scalp under the skin. There are many cases that are not suitable for this approach, ranging from the patient's anatomical issues to some surgeons' lack of access to endoscopes or experience with them. The research team found that, in a select group of patients, incisions through the upper eyelid resulted in equally effective release and deactivation of the nerves involved in migraines.

The researchers, who also included surgeons from Massachusetts General Hospital and Harvard Medical School, report 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. Nearly a third of the patients had between 50 and 80% of their symptoms resolved.

Thirty-five patients participated in the study. All suffered from chronic nerve compression migraine headaches confirmed by previous positive response to Botox or nerve block treatments.

More than 17% of women and 5% of men in the US suffer migraine headaches. One recent study reported that the burden of headache was highest in females 18-44, where the 3-month prevalence of migraine or severe headache was 26.1%, and head pain was the third leading cause of emergency department visits.

Migraine headaches can cause significant pain in one area of the head, often accompanied by nausea, and sensitivity to light and sounds. Migraines increase the risk of strokes, particularly those are preceded by an aura. Although some triggers have been identified, the chain of events in the brain resulting in migraine is not completely understood.

"Surgery is a valid treatment for migraines in certain patients," notes Dr. Oren Tessler, LSU Health Plastic and Reconstructive surgeon. "We believe that these patients should have ready access to migraine trigger site decompression surgery. Although larger studies are needed, we have shown that we can restore these patients to full and productive lives."