Have You Thought About Migraine Surgery?

March 5, 2013

Migraine sufferers are no strangers to disappointment — the disappointment that comes from trying a prescription medication that is supposed to stop headache pain or prevent it, only to find it doesn’t work. Or the disappointment that comes from discovering the side effects are nearly as debilitating as the migraine itself. For those who suffer from migraines more than 15 days per month, migraine surgery may be the logical next step.

While the thought of having surgery can make anyone nervous, some types of migraine surgery and minimally invasive options such as the Omega migraine procedure offer a distinct advantage over other surgical procedures: patients can get a pretty good idea about whether or not the migraine procedure will be successful before they actually undergo the knife.

Other migraine surgical options exist, as well.  When plastic surgeons noticed that Botox injections originally intended to reduce the appearance of wrinkles also had a surprising affect on their patient’s migraine pain, a new migraine procedure was born. Instead of going after wrinkles, Botox is injected into suspected muscles — suspected trigger points — in the forehead and other areas to pinpoint the precise muscles where pain is centralized during a migraine attack.

In a variation of the browlift, migraine-related muscles may be permanently removed, too.  Once the affected muscles have been correctly identified (for example, by Botox injections), the surgeon removes the muscles — and with them, hopefully, the source of pain. The preliminary Botox injections help both the physician and patient determine whether the migraine surgery will be successful.

With any surgical procedure, there can be some complications, including swelling and bruising around the eyelids; some hair loss at the incision site — although most incisions are very small and hidden in the hairline; and temporary numbness in the forehead caused by nerve damage that usually improves after the first four weeks.

Another type of migraine surgery, known as minimally invasive arterial surgery (MIAS), cauterizes superficial blood vessels in the scalp — terminal branches of the external carotid artery — that cause migraine pain. During this migraine surgery, the physician systematically compresses the blood vessels to determine exactly which vessels are responsible for the pain. When the correct vessels are compressed, the pain goes away. Cauterization of the appropriate vessels not only provides permanent relief from migraine pain, but also eliminates associated symptoms such as sensitivity to light and sound, aura, nausea and vomiting.

For patients who don’t want to have nerves or muscles paralyzed, permanently cut or cauterized (some daunting options, to say the least), the Omega migraine procedure is an alternative. Similar to implanting a pacemaker, this migraine procedure uses neurostimulation — small electrical pulses — to soothe the occipital and supraorbital nerves that transmit chronic migraine headache pain. Neurostimulation has been successfully used for more than 40 years to treat a variety of medical conditions, including back pain, spinal injuries and epilepsy.

Migraine surgery and minimally invasive migraine procedures provide individuals with more options for long-term relief from chronic migraine pain — options that allow them to stop taking prescription migraine medications.


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