Migraine surgery developed when Dr. Guyuron observed that patients who had injections of Botox for cosmetic purposes and patients who underwent brow lift surgery noted a significant reduction of migraine headaches. In Botox treated patients the headaches returned when the Botox wore off. In the surgically treated patients the positive effect was permanent. Many patients achieved complete elimination of their migraine headaches following this type of surgery.
A positive response to Botox predicts a 90% success rate for migraine surgery, with 35% of surgical patients achieving complete elimination of the migraines (migraine cure) and the remaining achieving a significant permanent reduction in their migraine frequency, severity and duration. Dr. Moore is the first plastic surgeon-migraine surgeon specialist to bring this beneficial surgical treatment to the Kansas City area.
Botox for Migraines
Botox injected into the muscles of the brow, eyes, forehead, and back of the head has been found to provide migraine relief reducing both the frequency and severity of migraine attacks. Botox has been reported to provide benefit to patients and may cause fewer side effects than many of the standard medications used to treat migraines.
Botox is also used as a diagnostic test to determine what trigger point(s) is causing the migraine and to determine if a patient with chronic, intractable migraine headaches will benefit from a more permanent surgical solution. The surgical technique -- performed by only a handful of plastic surgeons in the U.S. -- includes using Botox to pinpoint which of several specific muscles in the forehead, back of the head or temple areas may be serving as trigger points to compress, irritate or entrap nerves that could be causing the migraine. Because Botox temporarily inhibits muscle contraction, usually for about three months, it can be used as a trial test to see if a patient's migraine headaches go away or become less intense following a Botox injection. If a Botox treatment is successful in preventing migraines or lessening their severity, then surgery to remove the triggering muscle is likely to achieve the same result, possibly permanently. Botox treatments are used to determine if a patient will likely benefit from surgery.
Migraine Trigger Zones
Migraine headaches may be triggered by irritation of nerve endings in well delineated areas of the head and neck. The irritation of these nerve endings may eventually lead to a migraine attack. These nerve endings are located in 4 defined zones. Botox injections can be used to identify 3 of the zones; specifically the frontal, temporal and occipital migraine zones. Positive Botox responders are considered to be candidates for migraine surgery. It is important to note that some patients suffer from migraines involving more than one zone. Dr. Moore will determine which zone(s) are appropriate to address with migraine surgery. For the frontal, temporal and occipital zones, surgical candidates are those who respond positively to Botox injections of the specific zones.
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- Hyperhidrosis (severe underarm sweating or severe primary axillary hyperhidrosis)
- Increased muscle stiffness in elbow, wrist, and finger muscles with upper limb spasticity in people 18 years and older
- Abnormal head position and neck pain that happens with cervical dystonia (CD) in people 18 years and older
- Certain types of eye muscle problems (strabismus) or abnormal spasm of the eyelids (blepharospasm) in people 12 years and older
- Recurrent migraine headaches unresponsive to conservative therapy