In a recent study, the long term efficacy of surgical treatment for migraine headache was evaluated. This study was actually a continuation of the previous one-year study which included 125 participants, out of which 100 were surgically treated and 25 were grouped as controls. This prior study clearly showed that surgical therapy was very useful in eliminating the problem of migraine in some, while many others had very few symptoms of migraine linger. The present study was a follow-up of the same participants after their fifth year of surgical treatment.
Migraines are very common in the U.S., affecting 18% of women and 6% of men. It leads to decreased job performance and missed workdays, resulting in a total annual loss of $14 million, and is significantly under-diagnosed and undertreated. Drugs that are used in the treatment of migraine are expensive and are associated with many side effects. Almost 33% of patients are never benefitted by any form of pharmaceutical therapy. Migraine patients have certain “triggers,” stimulation which provokes an attack of migraine. In surgical treatment, surgeons remove or destroy these trigger points. In their routine practice, researchers had observed that surgical treatment is nearly curative in many of the patients with migraines. They wanted to confirm their observation by doing a randomized control trial.
Although rare, surgical treatment is associated with complications such as temporal nerve injury, neck stiffness, neck weakness, skin numbness, hypersensitivity, and hyposensitivity. Moreover, repeat surgeries are sometimes needed to eliminate the trigger points which are not identified at the initial stage. Apart from the trigger points which researchers have evaluated, there are other trigger points which are less common. Further studies should evaluate these trigger points as well, which may provide still more encouraging results. There was no control group to compare at the five year analysis, as most of them were surgically treated after the first year evaluation.
“This study not only confirms our findings from previous studies that the surgical treatment of migraine headaches in properly selected patients is likely to succeed but it also provides evidence that the obtained results are enduring.” In comparison to baseline values, 88% of the patients in the study showed that the results are both successful and lasting. The study also disproves that the placebo response effect is a significant factor in the outcomes and is a first in investigating the reasons that surgery might bring about migraine relief. The results point to a strong likelihood of surgical interventions causing a permanent decrease in intensity, frequency, and durations of migraines.
For More Information:
Five Year Outcome of Surgical Treatment of Migraine Headaches
Plastic and Reconstructive Surgery Journal, February 2011
By Bahman Guyuron, MD; Jennifer S. Kriegler, MD
From the Case Western Reserve University and the Center for Headache and Pain, Cleveland Clinic, Cleveland, Ohio