Migraine headaches may be caused by pressure on specific nerves in the head. John R. Barbour, MD, FACS, is a fellowship trained hand and peripheral nerve specialist and triple board-certified plastic and reconstructive surgeon who offers migraine headache surgery. Dr. Barbour offers the surgery for chronic pain experienced by migraine sufferers in the Washington, DC, area, including Fairfax, Arlington, Alexandria and surrounding communities in Virginia.
It is thought that sensory nerve irritation near muscle is involved in trigger sites for migraines. Some of these trigger sites can be targeted by surgical intervention. Trials with Botox in these areas can help determine if you are a candidate for surgery. Many people who suffer from migraines have several migraines each month. In patients who routinely have more than two migraines each month, it may be better to try to prevent the migraines from occurring (prophylactic therapy) rather than trying to stop them after they start (surgical therapy). The normal contraction and relaxation of muscles in the head and neck can squeeze nearby nerves, causing irritation that leads eventually leads to a migraine.
Botox (onabotulinumtoxin A) is FDA-approved for the treatment of chronic migraine headaches in adults. This helps to identify your personal trigger points for migraines. The effect of Botox takes about 5-7 days to start working and lasts for 3-4 months. Once Botox has been used to identify your personal trigger points for migraines, surgery can be performed to permanently release the muscle or nerve in the problem areas. You may have one or more trigger point areas that require surgical release.
Depending on the specific areas of migraine trigger points, muscle or nerve release surgery may be performed through an upper eyelid (blepharoplasty) approach or through the scalp.
Forehead Migraines typically start behind the eyebrows or between the eyes and may be worse in the late afternoon. One side may be more affected than the other. Treatment of the frontal zone focuses on the glabellar muscle group. Release and removal of the muscles can be performed directly through an incision in the upper eyelid.
Occipital Migraines often arise in the back of the neck and head before spreading. Occipital migraines are often initiated by stress or heavy exercise. This type of migraine is treated through nerve release surgery via an incision on the back of the neck to release the greater occipital nerve from the surrounding muscle.
For patients to be considered for migraine surgery, they must first:
- Be seen by a neurologist and diagnosed with migraine disease
- Report side effects or unsuccessful results from other treatment options
- Obtain a referral from your neurologist for evaluation for surgical treatment
- During your consultation, the Dr. Barbour will review your medical history and treatment goals. Treatment options, including risks and benefits, will be discussed in detail. We also ask that you bring a list of medications, vitamins and herbal supplements that you take, along with information on dosages. Migraine surgery typically takes an hour or two. All patients can go home the same day. Most patients return to work in about a week. You may experience relief from migraine symptoms immediately after surgery or in up to four weeks.
To schedule your consultation with Dr. Barbour, contact our office today.