Migraine surgery offers 'dramatic improvement' in small study

By Allen Cone  |  Updated Jan. 2, 2018 at 3:46 PM
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Jan. 2 (UPI) -- Migraine sufferers had "dramatic improvements" in functioning and coping after surgical treatment, according to survey data by researchers at Massachusetts General Hospital.

With headache frequency and severity reduced, the patients had a better quality of life, researchers report in a study published in the January issue of Plastic and Reconstructive Surgery.

"Our study demonstrates the high functional disability experienced by migraine patients, compared to those with other pain conditions, " Dr. William Gerald Austen, Jr., chief of plastic and reconstructive surgery at Massachusetts General Hospital, said in a press release. "The results also show that migraine surgery can lead to dramatic improvements in functioning and coping ability, even in patients who are very disabled before surgery."

The surgery, developed after doctors found migraine patients who underwent cosmetic forehead lifts also had fewer headaches, addresses trigger sites linked to migraine patterns. The minimally invasive procedure involves decompressing sensory nerves in the face and neck that can be involved in migraine headaches.

Massachusetts General Hospital's Migraine Surgery Program performs the surgical procedure for patients whose symptoms do not respond to standard medications or treatments.

Austen studied 90 patients who underwent migraine surgery between 2013 and 2015. Patients were evaluated using the Pain Self Efficacy Questionnaire, or PSEQ, before and after the surgery. The final analysis included 74 patients who completed both questionnaires, including one year after the procedure.

Before migraine surgery, the patients had "extremely poor" PSEQ scores, which indicates a high level of disability from the condition. The scores were significantly lower on the the survey than patients with other forms of chronic pain, including neuropathic and lower back pain.

One year after the procedure, patients had a 112 percent higher score on pain than the baseline for all conditions -- including a 19 percent improvement after nonsurgical treatment for low back pain.

"It seems that migraine surgery patients can recover function and ability to cope with pain very well after surgery, in stark contrast to what has been shown in other pain conditions," the researchers wrote.

The surgery also led to an average 76 percent improvement in the migraine-specific Migraine Headache Inventory score, measuring headache frequency, duration and severity.

"Chronic pain questionnaires such as the PSEQ add to our understanding of functional outcome after surgery and put pain in migraine surgery patients in perspective to better-known pain conditions," the researchers said.

Although surveys showed an improvement based on the questionnaires, the researchers noted "poor preoperative PSEQ scores do not influence outcome and should not be used to determine eligibility for migraine surgery."

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