Migraine Surgery

Migraine surgery is considered a relatively new development in the field of interventional pain management.  However, the concepts behind medical procedures to treat migraine pain have been in practice for many years.

Migraine surgery falls into two categories:

  1. Neurostimulation, which provides gentle stimulation to nerves associated with migraine pain
  2. Plastic surgery, which removes nerves associated with migraine pain
  3. Ear, nose and throat (ENT) surgery to address sinus-related migraine pain

Neurostimulation (“neuro” is Latin for “nerve”) was developed by a theory published in 1965 stating that nerve fibers provide information from two types of stimuli: one is pain, and the other is a combination of touch, pressure or vibration.  For example, this may explain why you may press against your head to relieve migraine pain.  Based on this theory, physicians have implanted spinal cord stimulators for the last forty years.  By providing a gentle vibration to nerves, these spinal cord stimulators are designed to create a gentle vibration sensation instead of pain.  Spinal cord stimulators have been used to address spine pain in situations where conservative treatments or corrective surgery would not provide relief.

In 2010, the official publication of the International Headache Society published research showing that neurostimulation could be used to address migraine pain, by targeting nerves in the forehead and the back of the head.  The Omega migraine procedure, based on this approach, provides migraine relief in a long-term, adjustable and reversible solution.

In a similar adaptation of an existing medical procedure, it has been found that a version of a brow lift can be used to remove nerves associated with migraine pain.  Research published in 2009 found that surgical remove of the corrugator supercilii muscle group (also known as the “frowning” muscle group) was able to treat frontal migraine headaches.  For temple migraine headaches, removal of a small branchof the trigeminal nerve treated the pain; and for occipital migraine headaches, located in the back of the head, migraine pain was treated by removing a small piece of muscle encasing the targeted nerve.

For those of you who suffer from sinus-related migraines, ENT surgery may be a viable solution to migraine pain.  A physician may clear sinuses using a balloon, or surgically adjust the nose septum.  These procedures have also been shown to successfully provide a long-term migraine relief.

The first step to any medical procedure is to talk to an interventional pain management specialist to receive an evaluation.  To aid your discussion, you can track your pain and attempts at treatment by using a migraine diary.   If you have a chronic migraine and have not found relief from conservative treatments such as pain medication, our staff of migraine specialists may be able to direct you to one of many medical procedures that could provide relief.  Fill out the contact form on this web page to learn more.

 

Reference:

Cephalalgia (2010, March 30). Combined occipital and supraorbital neurostimulation for the treatment of chronic migraine headaches: initial experience. PubMed. Retrieved February 3, 2012, from http://www.ncbi.nlm.nih.gov/pubmed/19732075.

University Hospitals Case Medical Center (2009, October 25). Surgery Potentially Best Option For Severe Migraine Headaches. ScienceDaily. Retrieved February 3, 2012, from http://www.sciencedaily.com­ /releases/2009/10/091025091142.htm