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Migraines caused by facial
muscles that interfere with certain nerves can be cured or dramatically
improved by surgically removing part of these muscles.
The nerves in question are
branches of the trigeminal nerve, which acts as both a motor and sensory
nerve in the face.
Surgeons can predict whether
or not the surgery will work by injecting BOTOX® into the muscle and determining
if paralyzing it in this way eases migraine.
When BOTOX® eliminated migraines,
the surgery was limited to partial removal of the corrugator supercilii
muscles. For those who did not experience complete resolution of the migraines
with BOTOX®, the surgeon also cut part of one of the branches of the trigeminal
nerve.
Twenty-one patients experienced
at least 50% improvement during follow-up of 222 to 494 days. Intensity
of headaches fell from 8.9 to 4.1 on a 10-point scale, while the frequency
dropped from 5.2 to 0.8 headaches per month. Two patients who failed to
respond to BOTOX® experienced complete elimination of their headaches after
undergoing plastic surgery to smooth forehead wrinkles.
Plastic
and Reconstructive Surgery June 2002;109:2183-2189
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