Surgery can treat migraine, says study

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A young woman holding her painful head

It makes sense to go under the knife to get rid of migraine, a study conducted by doctors from AIIMS Delhi and Srinagar military hospital has concluded. Their claim is based on follow-up results of 30 patients who underwent surgery to treat the neurovascular disease that affects 20% of the global population and is characterised by severe ache on one side of the head.

Conventionally, doctors prescribe analgesics and steroids to such patients for pain relief, but these medicines have known side-effects.

With surgery, the study claims, 14 (46.7%) out of 30 patients reported complete elimination of migraine after a year and an equal number reported significant relief of symptoms one year after the procedure. Only two (6.6%) patients failed to notice any significant improvement. The results have been published in the latest issue of the Journal of Craniofacial Surgery, a monthly US journal.

Dr Anson Jose, maxillofacial surgeon at Srinagar’s military hospital, who led the study, told TOI that surgery for migraine involved removing some muscles of the forehead or temples that are believed to trigger the attacks by compressing neighbouring nerve branches.

Surgical treatment of migraine is being done abroad on trial basis, but in India there have been few such attempts.

‘Removal of muscles gives long-term relief’

While patients are given botox injections at the trigger site, there is at least a 50% reduction in frequency and intensity of pain, surgical removal of these muscles provides long-term relief,” said Dr Ajoy Roychoudhary, professor and head, division of oral maxillofacial surgery at Centre for Dental Education and Research at AIIMS.

Bahman Guyuron, a US-based plastic surgeon, noticed the benefits of surgery in migraine patients in 1990’s while doing cosmetic procedures like forehead lifts.

Dr Roychoudhary said Guyuron observed that many of his patients, who were also suffering from migraine, reported significant reduction in headache. “This led to the beginning of research in this field,” the AIIMS professor said. He, however, cautioned that surgery may not be a solution for all.

Dr Kameshwar Prasad, professor and head of neurology at AIIMS said surgical management of migraines is an innovative experiment. “It presents a very diverse approach to treat migraine and may even prove ground-breaking in future. But we would require more studies….” he said. Migraine headache is a widespread neurovascular disorder, affecting nearly 20% of the world population.

A Delhi-based dentist, Priyanka Sharma (28), who underwent surgery last year, said “I… stumbled upon the possibility of surgery and opted for it. It has helped reduce the painful attacks significantly.”

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