The importance of the trigeminal nerve as a component of the pathogenic pathway for migraine headaches, has been studied for many years but its role in migraine genesis has not been identified until recently.
Some clinical researchers advocate surgical intervention for migraine prophylaxis, if the patients have a good response to Botox injections. We follow a strict case-selection protocol for these patients. They are assessed to exclude organic causes for the headaches; usually requiring a neurologist's consultation. The patients are then required to keep a log-book for one month prior to commencing treatment.
The log books are used to identify the site, severity and frequency of headaches prior to trial treatment with Botox. Log-book keeping is repeated after the first treatment.
If patients respond well to this then they are offered the option of continuing with Botox or permanently ablating the relevant muscles or nerves. These surgical manoeuvres aim to produce minimal functional or cosmetic morbidity.
Dr Peter Sylaidis offers this surgical migraine service to patients with debilitating migraines that are not controlled with simple analgesia. |
