Tuesday, August 4, 2009

Could Migraine Pain be Permanently Erased by Plastic Surgery?


Posted by Allie Montgomery on 3 August 2009

Have you ever had a headache so bad that you want to crawl back in the bed and hide under the covers? Well, you are not alone. Migraines are a debilitating pain that affect approximately 10 percent of the population, which is 30 million people in the United States alone. Nearly one in four households have someone that is afflicted by migraines.

For many patients, the normal over the counter medications just don’t work. Dr. Lawrence Newman, who is the director of the Headache Institute at St. Luke’s-Roosevelt Hospital In New York, said, “There is a subset of patients who have what we call chronic migraines. Many of those people are quite treatment resistant. Why? We’re not really sure. I tell our patients it is a life-altering condition. Having a migraine interferes with the person’s life, their family members, their friends, their co-workers.”

But now there may be hope for patients with migraines from a common plastic surgery procedure that was a discovery stumbled upon by accident by Dr. Bahman Guyuron, who is the chairman of the Department of Plastic Surgery at University Hospitals Case Medical Center in Cleveland. Guyuron stated, “I operated on a patient who came for a follow-up after a forehead life. Not only did she like the way she looked, she didn’t have migraines headaches for six months since the surgery.” Other patients that suffered from migraines before the surgery told him the same thing, that the forehead life had made their migraine pain disappear.

While the origins of these type of headaches are often a mystery, the research shows that the irritation of certain nerves in the face by nearby muscles might be to blame for some of the cases. Guyeron said that it would explain the improvement that his patients reported following their procedure because what he does is remove the muscles in the forehead that pinch the nerve.

Doctors have also noted that the patients that were treated with Botox often reported they had migraine relief. The researchers believe the Botox relieves the source of the migraines by paralyzing the muscles that surround the facial nerves. The next question is, could the forehead lift surgery offer a more permanent solution?

In Guyron’s small, double-blind study, he treated the patients with migraines either with an operation that targeted three common areas the trigger migraines, or a fake “sham” surgery, which acted as a control for the study. A year after the surgery took place, approximately 57 percent of the patients in the actual surgery group reported the complete elimination of their headaches, while only 4 percent of the sham surgery group did.

Some of the pain specialists that were not affiliated with the research said that the results were encouraging. Dr. Richard Lipton, who is the director of the Montefiore Headache Center in New York, noted that this study provides, “fascinating and promising results” that could benefit the patients that have high levels of pain and disability for whom other migraine treatments have failed.

However, some of the doctors said that the research findings may not be as conclusive as they appear at first look. While approximately 83 percent of the actual surgery group had a significant reduction in their migraine symptoms, so did approximately 57 percent of those that received the sham surgery.

Dr. Joel Saper, who is the director and founder of the Michigan Headache and Neurological Institute in Ann Arbor, Michigan, found that this high placebo response rate to the surgery is very troubling. “Overall, the study raises more doubts than provides answers. Surgery should be a last resort,” he stated.

Dr. Robert Shapiro, who is a professor of neurology at the University of Vermont College of Medicine in Burlington, agreed that the high rate of the patients who appeared to have improved through receiving the “sham” treatment suggested that the technique needs to be studied further. “It would be unfortunate if large numbers of migraines sufferers underwent expensive and potentially hazardous surgery which was actually no more effective than sham surgery. This study does not allow a conclusion to be drawn about the effectiveness of the surgeries performed.”

Resources: http://www.healthnews.com/family-health/could-migraine-pain-be-permanently-erased-plastic-surgery-3525.html

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