A “Cure” for Migraine Headaches?

June 25th, 2012 / Back to Blog »

You can OPERATE on people for migraine headaches?

Does it WORK?

These are two of the questions I get when I start talking about doing surgery to help people suffering with migraine headaches. To keep my answer short and easy to follow, the answer to both questions is the same:

Yes.

Ten years or so ago, a plastic surgeon in Cleveland – Dr. Bahman Guyuron – noticed that some of his patients who were having cosmetic surgery (a brow lift) commented that since the surgery, their migraine headaches had either completely gone away or had gotten much less severe. After some extensive research and review of the existing migraine literature, he began offering this surgery to people for the treatment of migraines.

Now, there is a growing body of literature that proves that operating on migraine trigger points to relieve the compression of the involved nerves can either cure or drastically decrease the severity of migraine headaches. Also, knowing that one of the insurance companies favorite means to deny permission for their policy holders to have this type of surgery was to call it “experimental”, a number of long-term outcomes and cost-analysis studies have been done.

What the current literature shows (very clearly, I might add) is that:

  1. Surgery to decompress migraine trigger points works in approximately 90% of patients, and approximately half of those patients are completely cured of their migraine headaches.
  2. Surgery ends up costing patients, their employers, and their insurance companies less over the long run than a lifetime of medication and lost days at work.

However, many patients are not aware that there may be a treatment option for them available outside of typical migraine medications. Also, the new “fad” in migraine treatment is the use of a nerve stimulator. In this procedure, which has been popularized by internet marketing campaigns (mostly funded by the manufacturers of the devices, which cost upwards of $60,000 each), an electric box is implanted under the skin of your back, and wires are run up your back and around the sides of your head. This stimulates the nerve endings in very specific ways to, essentially, turn them off and keep them from causing a migraine. It accomplishes something similar to nerve decompression. The downside, though, is that you’ve got an implanted device under your skin – forever – that can malfunction, run out of batteries, become infected, or misfire; problems you don’t have to worry about if you have nerves decompressed.

All that said, there are patients have had nerve stimulators placed and love them. And there are some folks that surgery doesn’t work for. No treatment is 100%, and it’s important for you, the patient, to do your research, weigh the options, and make the choice that’s right for you.

I’m including abstracts from two of the surgical papers on the topic worth reading. To me, the data speaks for itself. Call, email, or look me up on 2nd.md if you or someone you love has migraines and wants to hear more about the treatment.

And…as always, you can visit my Facebook page (Jason Hall, M.D.) and ask questions or discuss any topic – plastic surgery or otherwise. Don’t forget to “Like” me when you’re there!

Guyuron migraine 5 yr outcomes
A Socioeconomic Analysis of Surgical Treatment of.16