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Surgical Treatment of Migraine Headaches

Posted on 04. Jul, 2011 by wisdom.

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 http://www.teethremoval.com/occipital_nerve_block.html)

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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Root Canal Triggers Headache

Posted on 06. Aug, 2008 by wisdom.

I found an interesting article the other day written by a Chiropractor and describing how myofascial trigger points can mimic signs and symptoms of a neurological disease.

The case describes the patient as the following.

“A 44-year-old female, an office manager for a dentist for eight years, was referred by an EENT specialist with a chief complaint of headaches (HA), with a six- to eight-year history of HA and facial pain. Although all of her symptoms were usually on the right side of the face and head, the HA occasionally became bilateral when very intense. The facial pain was always located on the right. Once started, her symptoms lasted anywhere from four to ten hours. The only thing she remembers that may have triggered the onset was dental work done within six months of the start of the symptoms-several fillings and a root canal, all on the right side. Initially, the symptom was a pain in the upper molars, which appeared to be another cavity. Over the next few years, however, the pain developed into HA and facial pain.”

The article goes on to describe the different types of neuralgias that most closely resemble the symptoms experienced by the patient. Eventually myofascial triggers points were determined to be the cause.

“The patient was treated four times with adjustments to the cervical spine and intra-oral ischemic compression of the pterygoids. After the second treatment, her headaches and facial symptoms had disappeared. Eight months later, the headaches have not returned.”

To learn more and read the full article by Ronald Henninger which appeared in the Journal of the American Chiropractic Association in June 2002 visit the following link on the signs that mimic neurological disease.

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