medigraphic.com

2018, Number 1

<< Back Next >>

Cir Cir 2018; 86 (1)

Effectiveness of surgical treatment in chronic migraine

Amaya-Blas FJ, Mecott GA, Marfil-Rivera A, Tamayo-Esquivel ML, García-Pérez MM, Chacón-Moreno H, Pérez-Porras S, Coutiño R, Castro-Góvea Y

Language: English
References: 17
Page: 99-104
PDF size: 554.75 Kb.


ABSTRACT

Objective: Migraine affects more than 35 million people in the United States of America, and 10% of the population in the world. The purpose of this study was to evaluate the effectiveness of surgical treatment in chronic migraine with frontal or occipital trigger areas. Methods: We designed a pilot, proof of concept, and prospective study to analyze the effectiveness of surgical release of trigger nerves in severe frontal or occipital chronic migraines. The study was approved by the Ethics and Investigation Committee of Hospital Universitario Dr. José Eleuterio González (Monterrey, N.L., Mexico). We included patients diagnosed with chronic migraine by the neurology service of Hospital Universitario Dr. José Eleuterio González that attended our consult from March to December 2012. The patients were assessed by the MIDAS questionnaire and the diagnosis confirmed by injecting 2% lidocaine in the trigger sites. We realized a superior palpebral approach in frontal migraines to resection the glabellar muscles and an occipital approach to free the greater occipital nerve bilaterally. We evaluated complete and partial clinical response measuring the frequency, intensity, and duration of migraine episodes. Results: We included three patients with Stage IV (severe incapacitating) frontal or occipital chronic migraines. Two were occipital trigger sites and one frontal. We obtained complete clinical response in two patients and a partial response in one. Pain intensity decreased in all patients. Conclusion: Surgical treatment is effective in Stage IV (severe incapacitating) frontal or occipital trigger chronic migraines.


REFERENCES

  1. Lipton RB, Bigal ME, Diamond M, et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68:343-9.

  2. Larson K, Lee M, Davis J, Guyuron B. Factors contributing to migraine headache surgery failure and success. Plast Reconstr Surg. 2011; 128:1069-75.

  3. Faber C, Garcia RM, Davis J, Guyuron B. A socioeconomic analysis of surgical treatment of migraine headaches. Plast Reconstr Surg. 2012;129:871-7.

  4. Gilmore B, Michael M. Treatment of acute migraine headache. Am Fam Phys. 2011;83:271-80.

  5. Bartleson JD, Cutrer FM. Migraine update. Diagnosis and treatment. Minn Med. 2010;93:36-41.

  6. Kung TA, Guyuron B, Cederna PS. Migraine surgery: a plastic surgery solution for refractory migraine headache. Plast Reconstr Surg. 2011; 127:181-9.

  7. Guyuron B, Reed D, Kriegler JS, Davis J, Pashmini N, Amini S. A placebo- controlled surgical trial of the treatment of migraine headaches. Plast Reconstr Surg. 2009;124:461-8.

  8. Guyuron B, Varghai A, Michelow BJ, Thomas T, Davis J. Corrugator supercilii muscle resection and migraine headaches. Plast Reconstr Surg. 2000;106:429-34.

  9. Totonchi A, Pashmini N, Guyuron B. The zygomaticotemporal branch of the trigeminal nerve: an anatomical study. Plast Reconstr Surg. 2005; 115:273-7.

  10. Novak VJ, Makek M. Pathogenesis and surgical treatment of migraine and neurovascular headaches with rhinogenic trigger. Head Neck. 1992;14:467-72.

  11. Janis JE, Hatef DA, Reece EM, McCluskey PD, Schaub TA, Guyuron B. Neurovascular compression of the greater occipital nerve: implications for migraine headaches. Plast Reconstr Surg. 2010;126:1996-2001.

  12. Guyuron B, Tucker T, Kriegler J. Botulinum toxin a and migraine surgery. Plast Reconstr Surg. 2003;112:171S-3.

  13. Liu MT, Armijo BS, Guyuron B. A comparison of outcome of surgical treatment of migraine headaches using a constellation of symptoms versus botulinum toxin type A to identify the trigger sites. Plast Reconstr Surg. 2012;129:413-9.

  14. Behmand RA, Tucker T, Guyuron B. Single-site botulinum toxin type A injection for elimination of migraine trigger points. Headache. 2003; 43:1085-9.

  15. Guyuron B, Watkins F, Totonchi A. Modified temporal incision for facial rhytidectomy: an 18-year experience. Plast Reconstr Surg. 2005;115: 609-16.

  16. Poggi JT, Grizzell BE, Helmer SD. Confirmation of surgical decompression to relieve migraine headaches. Plast Reconstr Surg. 2008;122:115-22.

  17. Amparan-Estrada S. Management of acute migraine headache with lidocaine. Plast Reconstr Surg. 2005;116:335.




2020     |     www.medigraphic.com