Migraines affect more than thirty-five million people in America and cause significant morbidity leading to interference with work and home life. Despite the availability of a variety of medical treatments, some patients are unable to achieve complete relief. In these patients, treatment with Botox or even surgery can be a life-altering alternative. Some migraines are caused by pressure points or areas of irritation corresponding to sensory nerves within the head and neck. Alleviation of this pressure through muscle relaxation via Botox or surgical decompression can resolve or improve migraine symptoms.
Reasons for Choosing Treatment with Botox or Surgery
Usually, patients will choose treatment with Botox or surgery due to intolerance to medication side effects and incomplete or lack of response after medication trial. There are various causes of migraines; therefore, it is necessary to see a specialist for a complete evaluation to determine the appropriate treatment.
Migraine Treatment Candidates
The best candidates are men and women who meet the following criteria:
- The patient has seen a neurologist, headache specialist, or primary care provider to evaluate their headaches. Not all headaches are migraines, and a thorough history and physical exam are needed to determine the cause and type.
- The patient has tried medications for the treatment of migraine.
- The patient is generally healthy.
- The patient has physical exam findings that correlate with one or more trigger sites.
Your Migraine Consultation at our Denver Practice
An initial consultation aims to review pertinent medical history, perform a physical exam to identify possible trigger points, review treatment goals, and create a tailored treatment plan for each patient. Dr. Thompson seeks to provide relief from the debilitating migraine symptoms with both non-surgical and surgical methods based on the patient’s preference and response to therapy. If the patient has an excellent response to Botox and wants to avoid surgery, then serial Botox injections are a good option. However, some patients prefer a more definitive strategy and elect to proceed with surgical intervention.
The Surgical Procedure
The surgery focuses on targeting one or more sensory nerves located in the forehead, temple, and back of the head. It is usually an outpatient procedure performed under general anesthesia. Occasionally, surgery is done inside the nose to relieve pressure points from a deviated septum or other sites responsible for the headache. The details of each procedure will be discussed with each patient during the consultation. Dr. Thompson will ensure that all questions are answered and patients feel comfortable before proceeding with treatment.
Patients are usually back to work within two to three weeks from the surgery date. Most can resume routine activity shortly after the procedure and return to exercise within two to three weeks.
Anyone can have symptoms of a migraine headache. Approximately thirteen percent of Americans will experience symptoms of a migraine. Migraines occur about three times more commonly in women than men.
The exact cause of migraine headaches is still unknown but thought to be multifactorial and partly hereditary. Some potential triggers include stress, hormones, certain foods, alcohol, and weather.
One complication is that the migraines may persist. The vast majority of patients will experience complete resolution or significant improvement, but some may not get better. This situation may be due to scar formation after surgery, a second trigger site, or an unknown or unrelated cause of the migraine.
There may be a period of numbness followed by a tingling sensation in the weeks following the surgery. This symptom is usually temporary and resolves over weeks to months.