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Do you recommend or have any clinical experience with "migraine surgery"?

Peripheral nerve surgical decompression, i.e., "migraine surgery" is a controversial procedure mostly being advanced by plastic surgeons. The evidence is sparse from what I can tell, given our current understanding of migraine, and the AHS recommends against this. Is this something you have recommended for patients? How do you counsel them about this if they ask?
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Do you recommend migraine trigger site deactivation surgery in patients with refractory migraine?

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3 Answers
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Neurology · UPMC
Answered on

I do not as well. My understanding is that most of the plastic surgeons who perform this procedure have been trained by Dr. Bahman Guyuron, who developed the procedure. I think the published studies by Dr. Guyuron, showing some efficacy of this procedure, have a flawed methodology, and I do not thin...

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Neurology · Greater Boston Headache Center at Boston Advanced Medicine
Answered on · Updated on

I do not recommend surgery for my migraine patients, except occasionally minimally corrective endoscopic nasal surgery for removal of a bony contact, such as a spina coming off a deviated septum that sticks, very much like a splinter, into a turbinate. The surgery would always be part of comprehensi...

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Neurology · Brown Neurology
Answered on

I practiced in Cleveland for several years and had patients pursue this route of therapy with mixed results. My patient outcomes didn't match the study results cited above but a few patients did extremely well. It's not a therapy I would routinely recommend.

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