Surgical Treatment of Migraine Headaches

A study published in Plastic and Reconstructive Surgery shows that trigger site surgery may aid in reducing or even eliminating migraine headaches.

100 patients in a study underwent injection of botulinum toxin A (Botox) into up to 4 potential trigger sites. If a trigger site was identified to be effective than surgery was performed in that trigger area in order to decompress nerves and remove muscles.

71 of 79 patients that were evaluated over a 5 year period were observed to have improvement. This meant they had less mean migraine intensity and or less mean migraine duration.

20 of 69 patients (29.0%) reported elimination of migraines and 41 of 69 patients (59.4%) experience a significant decrease.

Surgery is not without risk and neither is injection of botulinum toxin A.  2 patients had hypersensitivity, 2 patients had hyposensitivity, and 2 patients had numbess at their 5 year follow up. This complications occured in the front region. 1 patient had occasional neck stiffness and 2 patients had occasional neck weakness which occurred in the occipital region.

I know from firsthand experience after having an occipital nerve block in attempt to end my 24/7 headache brought on by removing my wisdom teeth that injections into nerve and muscle areas in an effort to reduce headache can just make things worse as also indicated by this study. ( I discuss this more on

Therefore, anyone suffering from any headache condition should of course proceed with caution before having any injection and/or surgical procedure performed.  There are many different types of headache and jumping into any procedure that can just make pain and suffering worse is not well indicated. Even so an injection and/or surgical procedure can aid in helping those who suffer from migraine.

Due to the design protocol of this study there is no way to tell if the botulinum toxin A injection alone would produce similar results to it and the surgery.

Reference: Bahman Guyuron, Jennifer S. Kriegler, Janine Davis, Saeid B. Amini. Five Year Outcome of Surgical Treatment of Migraine Headaches. Plastic and Reconstructive Surgery. vol. 127. no. 2. 2010.

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