A Critical Evaluation of Migraine Trigger Site Deactivation Surgery

Authors

  • Paul G. Mathew MD, FAHS

    Corresponding author
    1. Department of Neurology, Brigham and Women's Hospital, John R. Graham Headache Center, Harvard Medical School, Boston, MA, USA
    2. Cambridge Health Alliance, Division of Neurology, Harvard Medical School, Cambridge, MA, USA
    • Address all correspondence to P. Mathew, Department of Neurology, Brigham and Women's Hospital, John R. Graham Headache Center, 1153 Centre St., Suite 4970, Boston, MA 02130, USA, email: pmathew@partners.org

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  • Conflict of Interest: The author reports no conflicts of interest.

Abstract

Migraine headache trigger site deactivation surgery is a term that encompasses 4 different surgical procedures that are performed based on headache onset location for the preventative treatment of migraine headaches. Multiple studies have demonstrated some efficacy of these procedures, but closer evaluation of the methodology of these studies reveals major flaws in study design. In this article, the author provides an overview of the procedures and presurgical screening tools, as well as a critical evaluation of 2 of the major studies that have been published. In addition, the author provides his opinion on future study designs that may help to better determine the potential efficacy of these experimental procedures and potential headache subtypes (contact point headache, supraorbital neuralgia, and occipital neuralgia) that may respond to peripheral decompression surgery.

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