How to Get Rid of a Migraine

What is a migraine?

Types of migraine

Migraine with aura, when certain warning signs appear just before the migraine starts, such as seeing flashing lights.
The most common type of migraine is migraine without aura, which occurs without differentiated warning symptoms.
Migraine with aura without headache, also known as silent migraine, is characterized by the presence of an aura or other migraine symptoms but the absence of headache.

Migraine symptoms

In addition to the headache, other common migraine symptoms include nausea and increased sensitivity to light and sound, which is why many migraine sufferers prefer to relax in a dark, quiet environment. Sweating, poor concentration, extreme heat or cold, gastrointestinal pain, and diarrhea are symptoms that some people occasionally encounter. These additional symptoms are not experienced by everyone who has a migraine, and some people may have them even if they don’t have a headache.
Before a migraine, about a third of people with migraines have transient warning symptoms called aura.
These are some of them: Numbness or a tingling sensation like pins and needles, which usually starts in one hand and goes up the arm before affecting the face, lips and tongue, feeling dizzy or off balance, slurred speech, loss of consciousness. Aura symptoms usually develop over the course of about 5 minutes and last up to an hour.
Aura may be followed by a slight headache or no headache at all in some people.

Causes of migraine

The exact cause of migraine remains relatively unknown. However, more and more studies show that migraine begins with compression of peripheral nerves in the head and neck. Through neural signaling, these compression effects travel to the brain and are responsible for the symptoms associated with migraines. It is also well known that the predisposition to develop migraine is genetically transmitted.

Migraine symptoms

In addition to the headache, other common migraine symptoms include nausea and increased sensitivity to light and sound, which is why many migraine sufferers prefer to relax in a dark, quiet environment. Sweating, poor concentration, extreme heat or cold, gastrointestinal pain, and diarrhea are symptoms that some people occasionally encounter.
These additional symptoms are not experienced by everyone who has a migraine, and some people may have them even if they don’t have a headache.
Before a migraine, about a third of people with migraines have transient warning symptoms called aura.
These are some of them: Numbness or a tingling sensation like pins and needles, which usually starts in one hand and goes up the arm before affecting the face, lips and tongue, feeling dizzy or off balance, slurred speech, loss of consciousness. Aura symptoms usually develop over the course of about 5 minutes and last up to an hour.
Aura may be followed by a slight headache or no headache at all in some people.

Migraine treatment

The common standard of care for the treatment of migraine patients can be divided into two categories: pharmacological and non-pharmacological. Pharmacological treatments include analgesic medications that help relieve pain during migraine episodes, abortifacient medications that help stop the progression of the episode and lessen its symptoms, and prophylactic medications that help prevent the occurrence of migraine episodes. Nonpharmacologic interventions commonly used to treat migraine include lifestyle changes (avoiding caffeine, tobacco, or alcohol), acupuncture, and massage therapies.
For patients suffering from severe acute episodes, nerve blocks with local anesthesia or sometimes steroids are commonly used to relieve symptoms temporarily. Botulinum toxin is a muscle relaxant that is also commonly used when a muscle compresses the trigger nerve. This last option usually lasts between weeks and a few months.5-7
Migraine surgery was discovered in Cleveland, OH, USA in 1999 when a plastic and reconstructive surgeon removed an eyebrow muscle during surgery on a patient suffering from chronic migraine. After surgery, the patient was cured of her migraine. This fortunate occurrence triggered extensive clinical studies evaluating the role of nerve decompression and symptom relief in migraine patients. Today, after hundreds of high-quality studies published in the most prestigious scientific journals and tens of thousands of patients treated around the world, it has become clear that migraine surgery is a highly effective and safe intervention. It has become the standard of care for migraine sufferers who do not respond to conventional treatments.

How do we treat migraine with surgery?

Migraine has been shown to be triggered by compression of peripheral nerves in the head and neck. These nerves can be compressed by an artery, ligament, muscle, or bone. Through migraine surgery, your surgeon decompresses these nerves from the surrounding structures that impinge on the nerve, thereby eliminating the entire cascade of neurological events that cause the symptoms.

What are triggers and how are they treated?

Frontal trigger point: Patients complain of a headache that begins above the eyes at the level of the eyebrows and travels up the forehead. These symptoms are caused by compression of the supraorbital nerve. This nerve comes out of the orbit and can be compressed by a small ligament over the eye or by the muscles that make us frown called corrugators. The treatment of this trigger is through a small incision in the upper eyelid, release of the ligament and removal of part of the muscles that cause compression.
Temporal trigger point: patients complain of intense pain that begins in the region of the temples and moves towards the forehead. This is commonly found in patients suffering from trismus (or clenching of the teeth). The nerve responsible for these symptoms is called the zygomaticotemporal nerve and is usually compressed by the temporalis muscle, which is a muscle of mastication. Treatment of this trigger is done endoscopically with a small camera in which the surgeon decompresses the nerve as it exits the muscle or removes the nerve completely, leaving no sequelae.
Occipital Trigger Point: Patients report severe pain that starts at the bottom of the head and travels upwards. This is commonly found in patients who have sustained whiplash injuries to the neck from car accidents or other trauma. The greater occipital nerve is usually compressed by one of the two neck muscles, the semispinalis or the trapezius. The treatment of this trigger is done through a small hidden incision in the scalp that removes part of the muscles responsible for the compression.
Rhinogenic trigger point: patients commonly report an implosive pain behind the eyes. It is usually exacerbated by seasonal changes. This is caused by contact between the nasal septum and the nasal turbinates. The usual treatment is a septoplasty and turbinate reduction.
There are other less common triggers. In the auriculotemporal trigger, patients describe a throbbing pain in front of the ear. This is treated with removal of the small artery under local anesthesia. Another minor trigger is the lesser occipital nerve, which has variable anatomy and is responsible for symptoms in the lower part of the head.

How successful are migraine surgeries?

Larger studies have shown us that almost more than 90% of patients who undergo migraine surgery obtain a significant improvement in their symptoms and more than half of these patients are cured. It is important to know that not all migraine sufferers are candidates for surgery. Each case must be evaluated individually. There are several forms that must be completed prior to seeing your surgeon in order to be considered a suitable candidate for this procedure.

How can I learn more about migraine surgery and find a specialist?

You can check the following websites:

Conclusion

Although there are very few experts in migraine surgery in the world, migraine surgery is not an experimental procedure since it has been scientifically and clinically proven that it can help patients who are suitable for this intervention. To date, the lives of tens of thousands of patients have been positively changed by migraine surgery.

Contact

Schedule a consultation

Reach out to our Patient Coordinator any time via e-mail, phone +34 933 821 111, or online form.