Cosmetic Eyelid Surgery Offers Significant Relief To Some Migraineurs: Study

Migraine Blog Eyelid

Eyelid Nerve Decompression Surgery Benefits Some Migraineurs (1)

What some migraineurs are willing to risk to shut off that pain. Turns out that getting under a knife that works on your eyelid is a risk well worth taking for them. This is not a procedure recommended for every migraineur. To be eligible for this eyelid cosmetic surgery, you need to meet certain criteria and thus screened to check if you should do this. The surgery essentially decompresses the nerves in the eyelid that trigger migraine episodes in many.

Dr. Oren Tessler, Assistant Professor of Clinical Surgery at LSU Health Sciences Center New Orleans School of Medicine, have seen that more than 90% of the patients who underwent this surgery experienced relief and also got a bonus cosmetic eyelid surgery. The study and it’s findings have been published in the medical journal Plastic and Reconstructive Surgery.

The study examined 35 patients all of whom suffered from chronic nerve decompression triggering migrainous episodes. All of them had used some sort of nerve blocking treatment earlier or Botox at some point of time trying to tackle the pain.

As per Dr. Oren, “Surgery is a valid treatment for migraines in certain patients. We believe that these patients should have ready access to migraine trigger site decompression surgery. Although larger studies are needed, we have shown that we can restore these patients to full and productive lives.” (2)

The eyelid nerve decompression surgery is an alternative to the much done endoscopic approach where sensors are passed under scalp skin. However, this latter method makes it unsuitable for many depending on their anatomy. Also endoscopes are not available with every team and neither is it safe to assume endoscopy expertise in ever surgeon. However, in the eyelid cosmetic surgery for the screened and selected patients simply involved making a minor slit in their upper eyelid resulting in release of the decompressed nerve and subsequent deactivation of the nerve involved in the migraine episodes. (3)

The team involved in the study also included surgeons from Massachusetts General Hospital and Harvard Medical School.

Some statistics on the surgery:

  • An overall positive response of 90.7%
  • Complete elimination of migraines in 51% of the patients.
  • 33% of the patients had between 50 and 80% of their symptoms resolved.

SOURCES

  1.  Caucasian Girl’s Blue Eye; Image Credit – Serge Bertasius Photography; Free Digital Photos; Web August 2014; http://www.freedigitalphotos.net/images/Younger_Women_g57-Caucasian_Girls_Blue_Eye_p154783.html
  2. Surgeons report significant migraine relief from cosmetic eyelid surgery technique; Eureka Alert; Web August 2014; http://www.eurekalert.org/pub_releases/2014-07/lsuh-srs073114.php
  3. Cosmetic eyelid surgery technique can help cure migraine: Study; Business Standard; Web August 2014; http://www.business-standard.com/article/news-ani/cosmetic-eyelid-surgery-technique-can-help-cure-migraine-study-114080101045_1.html

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Cut Out That Pain! Now, Surgery To Treat Migraines

A plastic surgeon at the University Of Texas South-western Medical Center has developed a new surgical technique that uses Botox which is generally employed for cosmetic surgeries in treating migraines.

New Surgical Technique Using Botox Promises Relief To Migraineurs (1)

In the procedure, the probable peripheral nerve triggers are first identified and then Botox administered at those sites during the surgery. These sites would be those that the doctor thinks are the ones contributing towards the migraine pain. This method is not recommended for everyone and is said to be prescribed to migraineurs on case-to-case basis.

Dr. Jeffrey Janis, has come up with this technique based on 5 years of study on anatomies of animals where nerves were decompressed to provide long-lasting relief to acute pain. In one of his recent studies, Dr. Janis exhibited the success of his technique. The study found that the use of Botox in the surgery led to average improvement of 85.5 percent over original symptoms such as frequency, severity and duration — but surgery produced a 96.6 percent average improvement over original symptoms.

However, according to Dr. Janis, “This type of surgery is not for everyone, but for those who have not found relief, these procedures are proving effective.” (2)

SOURCES:

  1. Image by Taoty; Free Digital Photos.net; March 2012; http://www.freedigitalphotos.net/images/view_photog.php?photogid=2692
  2. Botox, surgery effective migraine therapy; UPI.com; March 2012; http://www.upi.com/Health_News/2012/03/17/Botox-surgery-effective-migraine-therapy/UPI-27221331958592/

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Why NICE (U.K) Will Not Recommend Botox As Migraine Preventative Any Time Soon

National Institute for Health and Clinical Excellence (NICE) in the U.K will not be endorsing the use of purified botulinum toxin A (Botox) as a preventative for migraineurs anytime yet. According to sources, there is not enough evidence that confirms the efficacy of Botox in pain management. This news comes as a bit of a surprise especially because back in the summer of 2010, Medicines and Healthcare Products Regulatory Agency (U.K) had approved the use of Botox in migraine management. Here is a news report that runs in News- Medical.Net written by Dr. Ananya Mandal MD (1):

Botox Being Injected Into a Migraineur (2)

“Botox – used as an anti-wrinkle agent – is unlikely to be recommended for the treatment of chronic migraines on the NHS in England and Wales. According to the National Institute for Health and Clinical Excellence (NICE) draft guidelines there is insufficient evidence that it works.

Migraines are severe headaches, which are often accompanied by nausea and vomiting and finding light or sound painful. Chronic migraines are defined as headaches at least 15 days a month, eight of which have to be migraines.

In July 2010, Botox was approved as a preventive treatment for chronic migraine in the UK by the Medicines and Healthcare Products Regulatory Agency. Botox is injected into at least 31 sites around the head and neck every 12 weeks. However, how the neurotoxin might prevent chronic migraines is unknown. The therapy uses a purified version of botulinum toxin A and it is thought to block overactive nerve impulses which trigger excessive muscle contractions.

NICE is deciding whether the injection should be offered across the NHS in England and Wales. NICE said the injections had been “shown to have some benefit” such as in a trial involving 1,384 patients, published in the journal Headache. However, it said the effect was small and may have been confused by the way the studies have been conducted. A review in the Drug and Therapeutics Bulletin in February 2011 said there is “limited evidence” for using Botox.

Prof Carole Longson, director of the health technology evaluation centre at NICE, said, “Our independent committee is asking Allergan to provide further information and analysis as part of this public consultation, so that it has sufficient evidence to develop sound advice for the NHS regarding the use of Botox for the prevention of headaches in adults with chronic migraine. Without this additional evidence, potentially we will be unable to advise the NHS that this drug is good value for money for these adults because there are currently too many uncertainties.” NICE estimated the cost to the NHS would be £349.40 for every 12-week cycle of treatment.

Allegan said it was “working constructively” and would provide new evidence to NICE which it said would demonstrate “that treatment with Botox is both a cost effective and clinically meaningful treatment option for patients suffering from this debilitating condition”.

The chief executive of The Migraine Trust, Wendy Thomas, told the BBC, “I’m a bit disappointed really. For these people with chronic migraine, they’ve already tried various preventative treatments which have failed. For these people their only hope is Botox. It doesn’t work for everybody – it can change people’s lives or not make very much difference.”

Joanna Hamilton-Colclough, director of Migraine Action, said using Botox for her headaches had “absolutely transformed my life”. She said, “I’ve been having chronic headaches for 40 years – I wake up every day with a headache. After my first Botox treatment I woke up the next day feeling ill. At lunchtime I realized that I felt different because I didn’t have a headache. I’ve been able to work without a headache and sleep properly for the first time.” She admitted it did not work for everyone but added that clinical trials also suggested a 50 per cent reduction in migraine days for some patients.

Mrs Hamilton-Colclough said, “We don’t think the treatment is expensive when you take into account the cost to the economy from people needing time off work for migraine and to the NHS from A&E treatment.”

Professor Anne MacGregor, a migraine expert at St Bartholomew’s Hospital, London, said she was concerned Botox might be used as a ‘quick fix’ for chronic headaches. She added, “It’s not a blanket treatment but it might be appropriate for a small number of patients.”

A decision from NICE is expected in June.”

SOURCE:
1. Botox efficacy uncertain in treating migraine says NICE; Medical News.Net; February 2012; http://www.news-medical.net/news/20120218/Botox-efficacy-uncertain-in-treating-migraine-says-NICE.aspx

2. Image by Ambros; Free Digitial Photos; February 2012; http://www.freedigitalphotos.net/images/view_photog.php?photogid=1499