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When Should I Consider a Migraine Surgery Consultation?

Posted by Migraine Relief Center on Oct 3, 2018 1:45:00 PM

considering migraine surgery

People have suffered from migraines for as long as humanity has existed, and from the earliest times, we have searched for ways to relieve the pain. The ancient Romans made herbal teas from boiled peppermint and eucalyptus leaves, lavender and chamomile, and even tried applying raw chopped vegetables to the head. Fortunately, medical science has advanced since then, and we now have multiple methods of treatment. Migraine surgery remains something of a final resort, which is typically only used after other therapies have failed. Here are the common indicators that it may be time for you to consider scheduling a migraine surgery consultation.

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You’re Experiencing Chronic Migraines

Chronic migraine occurs when you experience a minimum of 15 headache days a month over a three-month period, of which eight or more each month are migraines, according to the International Headache Society. You might also discover that:

  • The headaches appear only on one side of the head at a time
  • The pain feels like it’s pulsating
  • Your headache gets worse when you do any routine physical activity
  • You become sensitive to light and/or sound, and develop nausea or vomiting as a result of the pain.

If you haven’t yet received a professional diagnosis about your headaches, it’s time to do so. Women have a three times higher risk of suffering from migraines than men, so take this into account.

You’ve Tried Everything Else

It’s important to remember migraine surgery is a treatment, not a cure. While many patients get some relief from various treatments, nerve decompression surgery is showing promising results. A study by researchers from Harvard Medical School shows 14% of patients undergoing surgery had less than 5% improvement. However, 17% had between 5% and 80% improvement, and an incredible 69% of patients showed more than 80% improvement. That’s an overall 96% whose migraines improved after surgery, which is quite impressive!

You’re Currently Enjoying Success with BOTOX® Treatments

Migraine patients currently in a BOTOX® treatment plan are in the ideal position to consider migraine surgery. Research shows patients who are not responsive to BOTOX® are not likely to benefit from migraine surgeries, but for those who get limited or short-term relief from the therapy, surgery could be a more reliable and permanent solution that eliminates the need for regular BOTOX® injections.

You’re a Potential Candidate for Migraine Surgery

Migraine surgery usually takes the form of nerve decompression, and some patients are better candidates than others for this. Surgery could be an option for you if you suffer from symptoms that predict a positive response to the procedure. These are:

  1. A frontal headache, which has an imploding type of pain above the eyebrows that usually occurs in the afternoons, tenderness at the supraorbital notch, and a drooping eyelid. This is often triggered by stress.
  2. A temporal headache, which occurs at the side of your head with pain in the front part of the temple. This headache is more common in the mornings, and patients’ teeth often show signs of wear from grinding.
  3. An occipital headache, which can begin at any time of day and mostly affects the back of the head. Patients often have a history of whiplash or neck trauma, and symptoms include tight neck muscles and tenderness over the nerves in the area. These headaches can be triggered by stress or heavy exercise.  
  4. A rhinogenic or nasal headache characterized by pain behind the eyes and a runny nose. This headache usually occurs on waking or in the evening and can be related to seasonal allergies or changes in menstrual cycle. Symptoms include an exploding pain sensation.

If the conditions seem right for BOTOX® treatment, patients with these headaches often respond well to this option. BOTOX® is the use of a highly-diluted botulinum toxin, which decompresses the nerves at the trigger points, preventing the muscle contractions that cause migraines. If a patient responds well to BOTOX®, they usually are good candidates for a surgery, which will usually give more lasting relief.

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Your Migraines Could Cause Other Medical Problems

Patients who have experienced migraines for a number of years could have a higher risk of developing other medical issues caused by the pain. Research shows that patients who have a history of migraines with aura have double the risk for ischemic strokes. These occur when a blood vessel in your brain becomes blocked and stops the supply of blood to part of the brain. There’s also substantial anecdotal evidence that frequent migraines—and the drugs patients use for relief—can contribute to memory loss and cognitive dysfunction.

Going to a Migraine Surgery Consultation

No matter where on the scale of migraine treatment you’re at, scheduling a migraine surgery consultation is an excellent opportunity to gather all the data you need to make an informed decision. Why wait until you’ve tried every costly treatment option in the book before you investigate the procedure that’s currently producing the highest rate of success?

A consultation will provide your migraine surgery practitioner with a chance to review why your migraines occur and how they typically behave. He (or she) will evaluate your symptoms, the migraine stages you typically experience, including the prodrome, aura, attack and postdrome phases, and the risk factors that can predispose you to chronic migraines, such as family history, age, gender, and hormonal changes.

What to Expect During a Migraine Surgery Consultation

When you schedule a consultation, your surgeon will start by performing a physical exam and asking you about your migraine episodes. You’ll complete a medical questionnaire about your family history and your migraine headaches, and you might be asked to keep a daily migraine diary about your symptoms for a time. The migraine surgery practitioner will discuss the various types of surgical treatment with you, to find out which option might be the best one for you.

During the evaluation process, you’ll have the chance to consider the supraorbital nerve decompression procedure and the greater occipital nerve entrapment surgery. Both of these are minimally-invasive options, and if neither is right for you the surgeon might suggest a septoplasty procedure or BOTOX® alternative. The surgeon might also recommend giving you a steroid or BOTOX® injection as a test to determine how well your headaches respond to the treatment. You’ll then be required to keep a diary about your experience in the weeks following the test.

Taking the First Step

Deciding whether to take the first step by having a migraine surgery consultation is exciting and challenging. If you experience any of the indicators, it could be the right time to consult with a migraine surgery professional. There is presently a high rate of success to be gained with these surgeries, although they are still in the experimental stage and are not covered by most insurance companies.

Chronic sufferers who continuously experience debilitating migraines have nothing to lose and much to gain from these procedures, but you should first consider the costs and risks. Patients who only experience episodic migraines should first explore medication treatment plans before considering BOTOX® or surgery.

Schedule your migraine surgery consultation today and find out if you’re eligible for one of these promising procedures. 

patient guide to surgery

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Topics: Treatment, Migraine

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