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How Could Plastic Surgery Alleviate Migraines? And Why Are Some Neurologists Wary?

Heather Crowe’s migraines began when she was in junior high.  The pain was blinding, and when they happened, she couldn't do anything except stay in bed.  She suffered for years, until she became a nurse and started working for Dr. Jimmy Waldrop at the Erlanger-housed Plastic Surgery Group.

Dr. Waldrop told Crowe about a new treatment option—a surgical procedure never before performed in Chattanooga.  The surgery involves operating on trigger points in the face/head that are thought to cause migraine pain.

Crowe had the surgery in December of 2013 and reports she’s nearly migraine-free now.

“Honestly,” she says, “I've not had one in so long now, it's kind of hard to remember having them so frequently.”

Some plastic surgeons are enthusiastic about this treatment, includingDr. Bahman Guyruon, who pioneered it over a decade ago.  Located in Chicago, he’s the Chairman of the Department of Plastic and Reconstructive Surgery at University Hospitals Case Medical Center and a professor at Case Western Reserve University. 

Dr. Guyuron discovered the treatment by accident.  In this audio segment, he explains how it happened, and how it’s theorized to work.  He says he does the surgery hundreds of times a year and has published 24 scientific articles indicating it helps patients.

“It depends on your symptoms and type of migraine headaches that you have,” he says.  “Close to 90% the patients we have, that we operate on, have at least 50% reduction in their migraine headaches.”

However, some neurologists question the research’s validity.  It’s been published in plastic surgery journals, not neurology journals.  The American Headache Society issued astatement saying, “In our view, surgery for migraine is a last-resort option and is probably not appropriate for most sufferers.”

Dr. David Dodick is a neurologist at the Mayo Clinic, as well as the past president of the American Headache Society and the Chairman of the American Migraine Foundation.  “I'm all for new, creative and innovative ways to treat this disorder,” Dr. Dodick says, “which is devastating for millions of people across the country.  But I also don't want to expose them to a costly surgical procedure which may lead to adverse events, or adverse effects, we can't control.”

In this segment, Dr. Dodick explains why he’s saying more research needs to be done.

“Let's come together as an international community of experts,” he says, “both on the migraine side as well as the plastic surgery side, and see if we can build consensus on a study design that we're all comfortable with.”