Is Botox Becoming a Candidate Test for Migraine Relief Surgery?


Migraines have been reported in individuals as early as 3,000 B.C. and yet, the condition is still widely underrated and misdiagnosed. But with modern medicine and a recent boom of studies, relief from chronic pain is getting closer. Treatment was once a game of trial and error, testing multiple medications, diets and lifestyle adjustments to avoid triggers and manage pain. Today, science is better understanding the actual cause of chronic migraine syndrome and with that knowledge, more effective treatments are emerging.

Migraine Relief Surgery

It is believed that migraine pain is caused by the involuntary stimulation of peripheral sensory nerves, which activate blood vessel dilation. These stimulation sites are also referred to as trigger points. By removing nerve sections or surrounding muscle responsible for nerve stimulation at these trigger points, migraine relief surgery provides long-term reprieve from pain.

There are four main migraine trigger point areas to which surgical intervention can be applied:

  1. Frontal
  2. Temporal
  3. Occipital
  4. Nasal

Studies have determined that in 93% of surgical patients, a 50% reduction in the Migraine Headache Index is experienced and 35% of patients report complete relief.

To be considered for surgery, you must be diagnosed with chronic migraine syndrome, which is characterized by migraine pain at least 15 days out of every month for four hours or longer per episode.

What is Botox?

If you’ve been in the migraine game for a while, chances are you’ve heard of Botox, a drug derived from the bacteria Botulin. Botox is used to treat muscle conditions and is more commonly known for its use in the cosmetic world as a facial muscle relaxant that reduces or eliminates the appearance of wrinkles.

Botox for Migraine Treatment

In 2010, the Medicines and Healthcare Products Regulatory Agency (MHRA) approved Botox for the short-term treatment of chronic migraine pain. The exact science behind its effectiveness is unknown but doctors believe the Botulin temporarily abates muscles that impinge on nerves and cause migraine pain.

Botox for Migraine Relief Surgery

Botox as a solo treatment isn’t the only way physicians are using the drug. Of the 60-80% of patients whose migraine pain is improved with Botox, 90% experience relief with surgical intervention, making Botox a potentially accurate indicator of who might be an ideal candidate for surgery.

Before surgery is scheduled, patients undergo Botox treatment to determine which trigger points are responsible for their pain. Up to eight weeks thereafter, patients are asked to keep a migraine diary to track the frequency and severity of symptoms. If pain, duration or frequency is temporarily improved with Botox, surgical intervention is considered for long lasting results.

The effectiveness of migraine relief surgery is still a heavily debated topic, as some physicians believe the placebo effect (a patients belief in treatment) may be responsible for skewing test results. To learn more about migraine relief surgery and the role of Botox as a candidate indicator, schedule an appointment with your migraine doctor.

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Image Source: Kreg Steppe

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