Migraine F.A.Q.

/Migraine F.A.Q.

Migraine Surgery FAQs

Below are some of the most frequently asked questions about migraine diagnosis and surgery. We hope you find these answers to be helpful. However, if you still have additional questions after reading this page, please do not hesitate to contact The Migraine Institute.

FAQs

Below are some of the most frequently asked questions about migraine diagnosis and surgery. We hope you find these answers to be helpful. However, if you still have additional questions after reading this page, please do not hesitate to contact The Migraine Institute.

A migraine is a type of headache that generally causes severe, throbbing or pulsating pain on one side of the head, associated with nausea, vomiting and avoidance of bright lights (photophobia) and loud sounds (phonophobia). Migraines can last from two hours up to three days. Although migraines can be diagnosed by a primary care doctor, in order to be considered for surgery you need to have a diagnosis from a neurologist.

All migraines are headaches, but not all headaches are migraines. Headaches are a large category describing all ailments that cause pain in the head. A migraine is a type of headache. The definition of a migraine will help you identify the difference between the pain of a headache and migraine. To find out if you are suffering from migraines versus a headache, you should schedule an appointment with a neurologist who can make the diagnosis.

To be properly diagnosed with migraines, you need to see a neurologist. Your neurologist will evaluate you to determine if you are in fact suffering from migraines.

Every patient is unique and has their own set of triggers that cause their migraines. However, there is still no exact mechanism proven to cause migraine headaches. Most believe that migraines are caused by a combination of factors that ultimately trigger a cascade of events to cause migraine pain.

If you have symptoms suspicious of migraines, the best first step is to consult with your primary care doctor and/or a neurologist to confirm that this is, in fact, migraines. If you are diagnosed with migraines, a trial of lifestyle changes, alternative therapies, and migraine medications will likely be recommended.

There are several treatment options available for migraines, but keep in mind that each patient responds differently to treatment options. It may be frustrating as you try several treatment options that work for others that simply do not work for you. We know that it can be difficult and are here to support you in every way possible. The most common treatment options include lifestyle changes, alternative therapies (acupuncture), medication, BOTOX® and surgery.

If you are a chronic migraine sufferer with incomplete relief or severe side effects from medications, Dr. Cabin of The Migraine Institute offers personalized, highly-effective migraine treatments to address specific migraine triggers.

Today, migraine surgery is effective to treat migraines caused by one of four muscular/nerve trigger points. Three muscular/nerve trigger points are around the scalp and one is inside the nose. Other trigger sights have been suggested and are being studied, but are not currently treated with surgery.

Before undergoing surgery, we will “test” your triggers by using Botox® injections for the three scalp trigger points and nasal spray for the nasal trigger point. If the Botox® or nasal spray help reduce your migraine pain, then you are most likely confirmed as a candidate for migraine surgery.

Migraine surgery generally takes one to three hours depending on the location and number of trigger points. Dr. Cabin will explain how long he expects your surgery to take during your pre-op appointment.

We do everything we can to make sure you do not have any visible scars after migraine surgery. During a migraine surgery, a facial plastic surgeon will administer one or more small incisions within the hair or scalp. The incisions will be hidden within the eyelid creases and typically heal with no visible scar.

With a nasal trigger point, a facial plastic surgeon will make the incisions within the nose. The incisions will be hidden within the nose.

We perform minimally invasive migraine surgery at an outpatient surgery center, which means you can go home after a procedure is completed. Sutures are removed one week after surgery. In many instances, patients will be able to go back to work after about 7 to 10 days, but need to restrict their actions for at least a few weeks. Typically, Dr. Cabin will provide details about the recovery process, along with when you can restart your regular exercise routine.

The side effects of migraine surgery are similar to most surgeries. Bruising and swelling around the eyes is common after migraine surgery, but these symptoms will disappear within about one to two weeks. The combination of ice, anti-bruising medication and ointment, will be prescribed by Dr. Cabin to help ensure a patient’s recovery moves along smoothly. Pain is generally minimal, and you will be prescribed pain medication to use in the days after surgery. You may also receive antibiotics to mitigate the risk of infection. If you are experiencing significant pain during your recovery, do not hesitate to contact our office.

You can expect a significant decrease in migraine pain following your migraine surgery. Depending on your migraine trigger sites, you may notice improvement immediately. However, it takes some patients weeks or months until the full effect is felt. The majority of patients notice improvement two to four weeks.

Although uncommon, there is a chance your migraines will not significantly improve. This is usually related to additional trigger sites that are now noticeable after the removable of the primary sites, and can usually be treated with an additional procedure. It is very rare for there to be no improvement after surgery.

Migraine symptoms include:

  • Dizziness
  • Fatigue
  • Nausea
  • Sensitivity to light (photophobia)
  • Sensitivity to sound (phonophobia)
  • Vomiting

A person who experiences any of the aforementioned symptoms for more than a few hours should consult with their primary care doctor or neurologist to discuss a migraine diagnosis and potential treatment. If you are diagnosed with chronic migraines, you should consult with Dr. Cabin for the latest, cutting-edge treatments.

Not all migraines are diet-related, but there are many migraine triggers linked to specific foods a person eats. In addition, both low blood sugar and sudden spikes in blood sugar have both been shown to trigger migraines in many individuals.

Aside from diet, most migraine sufferers have specific environmental triggers that lead to migraine symptoms. These triggers may include:

  • Alcohol
  • Contraceptives
  • Dehydration
  • Emotional anxiety
  • Exercise
  • Medicines
  • Physical factors

There are four potential migraine stages:

  1. Prodrome: Takes place one to two days before a migraine attack and causes physical and emotional symptoms.
  2. Aura: Acts as a “warning” leading up to a migraine attack.
  3. Migraine Attack: Involves moderate to severe pain that affects one side of the head.
  4. Postdrome: Results in a hangover-like feeling that usually persists for about 24 hours.

Each migraine stage caries in length and severity, and a migraine sufferer may experience only the migraine attack stage, or any combination of the other stages.

Studies have shown a child with one parent who suffers from migraines has about a 50% risk of developing migraines. If both parents deal with migraines, a child’s risk of migraines increases to approximately 75%. In addition, researchers have found as many as 90% of migraine sufferers have family members who also deal with migraines.

Typically, migraines are based on a combination of genetics and environmental factors.

Many people believe a migraine is a type of temporary stroke, but little evidence suggests those who deal with migraine symptoms are more likely than others to suffer a stroke. A migraine and stroke may occur at the same time; in this instance, there is likely a relationship between the two.

Approximately 35 million Americans – or 12% of the population – suffer from migraines. The majority of migraine sufferers fall between the ages of 35 and 45 years old. The prevalence of migraines is greater in women (12%) than men (6%) suffer from migraines.

Migraines are often disabling to “migraineurs”, or people that suffer with migraines, and can last anywhere from 4 hours to 3 days – sometimes even longer. They may occur as often as several times a week to only once a year.

There are several types of migraines. Many people with migraines may suffer with more than one type. The two most common types are migraines without aura, formerly known as “common migraines”, and migraines with aura, formerly known as “classical migraines.” Aura accompanies approximately 25% of migraines and typically involves visual symptoms, such as zig-zag lines, blurry vision, temporary vision loss or flickering lights. Aura usually commences before the onset of the headache and can last anywhere from 15 minutes to 1 hour. Other specific migraine types that are recognized by the International Classification of Headache Disorders (ICHD) include:

  • Chronic migraine
  • Complications of migraine
  • Probable migraine
  • Episodic syndromes that may be associated with migraine.

Additionally, subsets of migraine with aura include hemiplegic migraine, basilar migraine, vestibular migraine and aura without migraine, which are all pretty rare.

Ocular migraines may go by other names, such as visual, retinal, ophthalmic or monocular migraines. The term “ocular” means “pertaining to the eyes.” By now, you must know that migraines can be accompanied by visual problems. These visual disturbances are termed “auras” and usually occur in both eyes. What sets ocular migraines apart is that the visual problems occur in only one eye. It can be hard to discriminate whether you’re having symptoms or not in one eye only. If you’re not so sure, cover one eye and then the other.

If you have been diagnosed with migraines, you should be able to learn your personal triggers for the condition over time. No one has been able to definitively identify a cause for migraines. However, there have been some triggers for the condition that have been pinpointed. Stress is one of the most common triggers for migraines. There are a number of foods, drinks and food additives that may provoke the onset of migraines, including alcohol (e.g., red wine); caffeine; nitrates (commonly found in cured meats such as pepperoni, hot dogs and lunch meats); monosodium glutamate (MSG); the artificial sweetener aspartame, and some aged cheeses, sauerkraut and soy sauce, which contains the migraine-inducing chemical tyramine. Other potential triggers may include fatigue/sleep problems, weather changes, skipping meals and menstruation or pregnancy.

One of the best methods to prevent a migraine is to avoid your particular triggers and other general measures such as staying hydrated, getting quality sleep, not skipping meals, quitting smoking, reducing stress and exercising regularly. When these measures are not able to prevent or decrease the frequency of your migraine attacks, you may be a candidate for preventative medications. These preventative medications are usually taken daily and are not to be used for the treatment of an acute episode of migraine. Choosing medications for preventive therapy of migraines can be a complex process and is best accomplished in consultation with your neurologist. Preventative treatment may be required for 6 to 12 months or longer. The overall goal of preventative migraine treatment is to take fewer drugs, avoid harsh side effects and have better control of the condition.

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