Clarify Statement About Migraine Trigger Site Surgery?

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Full Question:

I have a question regarding the article "5 Things Migraine and Headache Patients and Doctors Should Question." Could you please further explain #3, "Don’t recommend surgical deactivation of Migraine trigger points outside of a clinical trial?"

I have a fuzzy but not clear picture of what this is and would like to know more. Roni.

Full Answer:

Dear Roni:

The position the American Headache Society (AHS) and many others have at this point is that there haven't been enough properly conducted clinical trials to prove either the efficacy or safety of migraine trigger point deactivation surgery (MTSDS). At the 2014 annual scientific meeting of the AHS, a research poster summarized the trials that had been done, studied the methods employed in those studies, and pointed out problems with them.

The conclusion of that research poster was:

"MTSDS may be useful in a subset of migraine patients with or without coexisting headache disorders, but the supporting data at this time are not convincing. In addition to unclear efficacy, these procedures can also have complications including worsening pain and permanent itching. These procedures are often not covered by insurance, and can have an out of pocket cost of $10,000 - $15,000. Future studies should include imaging that demonstrates clear surgical targets that involve nerve compression (supraorbital neuralgia, occipital neuralgia) or intranasal contact points (contact point headache). MTSDS should be considered experimental at best based on available data, and patients considering surgery should have it performed as part of a clinical trial."

You can read more about this topic in Migraine Trigger Site Deactivation Surgery - Ready for Prime Time?

We’re always excited about and encourage new treatment research, and that some or all of these procedures may eventually be proven effective. But we must also always be cautious, especially with invasive treatments, because the desperation caused by severe recurrent migraines can cause people to pursue things that may not be the best option.

Thanks for your question,
David Watson, MD, and Teri Robert

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About Ask the Clinician:

Dr. David Watson is a UCNS certified migraine and headache specialists and director of the Headache Center at West Virginia University. He and Lead Health Guide Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about _ Dr. Watson_ or more about _** Teri Robert** _.

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