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New technique effective for migraines

Article-New technique effective for migraines

Cleveland — Surgery to “deactivate” migraine headaches produces at least partial relief at five years’ follow-up for nearly 90 percent of patients who undergo the procedure, reports.

Bahman Guyuron, M.D., chairman of plastic and reconstructive surgery, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, developed the migraine surgery techniques after noticing that some migraine patients had reduced headache activity after undergoing cosmetic forehead-lift procedures.

The techniques consist of “surgical deactivation” of “trigger sites” in the muscles or nerves that produce pain. For patients with frontal migraine headaches starting in the forehead, for example, the muscles in that area were removed, just as they are in a forehead lift. Other approaches target other migraine trigger sites.

The study involved 69 migraine patients. Before surgery, each patient was tested with botulinum toxin A to confirm the correct trigger sites. For most patients, surgery targeted at least two trigger sites.

Results show that 88 percent of these patients had a positive long-term response to surgery. Headaches were significantly decreased in 59 percent of patients and completely eliminated in 29 percent. The remaining patients had no change in headache activity.

The findings “provide strong evidence that surgical deactivation of one or more trigger sites can successfully eliminate or reduce the frequency, duration and intensity of migraine headache, and the results are enduring,” the researchers write. They conclude that more research is needed, both to refine surgical techniques and clarify the reasons that surgical deactivation of trigger sites relieves migraine headaches.

The study appears in the February issue of Plastic and Reconstructive Surgery.

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