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Surgical Options

Nerve Decompression Surgeries

  • By Jessie Brown

    I have tried everything to reduce the daily chronic migraines. This year I had 3 nerve decompression surgeries and 1 follow-up: Occipital, Temporal, and Frontal. I have not had any changes in the severity of my migraines, the only positive outcome is that my neck and shoulders don’t hurt nearly as bad from the occipital decompression. Has anyone had any luck on any of these surgeries?

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  • By Nancy Harris Bonk Moderator

    Hi Jessie Brown,

    Thank you for sharing your story with us. I’ve not had this surgery, but hopefully others will be along shortly to share their experiences with you.

    It may feel as if you’ve tried everything for migraine, but that really may not be true, so don’t lose hope! There are over 100 medications that can be used to treat migraine, and if you add up the different combinations, that number goes up greatly. And it would take 25 years or so to try each medication in the correct manor, at the proper dose. Let me share more information with you on this; https://migraine.com/blog/migraine-management-essential-4-preventive-treatment/.

    Migraine is thought to be a genetic neurological disorder that is managed, not cured at this time. Trigger identification and management plays a vital role in a good migraine regime. Have you kept a detailed migraine diary recently? If not I would encourage you to do so because if we can identify and manage our triggers, we may be able to reduce our attack frequency and severity. Continue reading this article for more information; https://migraine.com/blog/keeping-migraine-diary-basics/

    Invasive surgeries may temporarily reduce one trigger and help with pain, but most of us have many more triggers to contend with. We do have some research on nerve compression surgeries that are not real positive. Let me share this with you here; https://migraine.com/blog/migraine-trigger-site-deactivation-surgery-studies-not-convincing/.

    Keep us posted on how you are feeling,
    Nancy

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  • By paulette

    Hihi there Jesse I had nerve decompression surgery I had six sites done and I still have migraines I’m 3 months out of surgery I my migraines come as they feel like it prior to the surgery I had migraines everyday all day and no medication was working anymore I had built a tolerance I guess nothing was working and I have gone to many doctors in New England and all around I think the severity intensity of the migraine are far more tolerable they’re not as intense before the surgery it felt like somebody just took a gun shotgun and blew part of my head off it just was intense I don’t know how far you know your surgery when I did themi was at the end of my rope technically I’m still in the honeymoon period where I shouldn’t be having any headaches soma little nervous

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  • By rosie.smiles

    I had migraine surgery done six weeks ago on my temples, back of head, above my eyes, and nose. It really worked! My head is still sore and numb at some places, but it’s improving. My migraines are SO much better. It’s like night and day difference. Oh, and neither Botox nor nerve blocks helped me before, but the surgery still worked. I got improvement almost immediately. What my doctor does has a 90% success rate and he’s never had anyone get worse. So sorry for all those that weren’t helped or got worse through surgery.

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  • By paultxrn

    I’m looking at both occipital nerve stimulation as well as nerve decompression. I’m fortunate that Bardia Amirlak is here in Dallas (considered a expert in nerve decompression). I also have access to the Omega procedure (nerve stimulator). Which one is a better option? Anyone have both?

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    • By rosie.smiles

      Paultxrn,

      I had nerve decompression surgery. Although I do not have any experience with the Omega procedure (I didn’t need to–the nerve decompression surgery I had worked GREAT!), I have read about it some. From what I know about both procedures, I would definitely recommend nerve decompression (I am trying to be unbiased here). For one thing, with nerve decompression, you have nothing implanted at all. You heal up (of course it can take awhile for the feeling to come back, but that was/is not a big deal to me) and then that’s it. People have no idea, unless they were told, that I had surgery on multiple spots around my head–everything is hidden so well. There’s no wires or batteries or anything. Another thing is, with anything manmade, there is always the chance of it malfunctioning. Also, are follow-up surgeries required to maintain the battery? If so, that is not something I would want to go with. I’m no doctor, just a former migraine sufferer happy to have finally found something that worked and living a more normal life than I have in a long time. I share my experience in hopes that it will help someone else. I wish you the best…

      ~Rosie.smiles

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  • By paultxrn

    Thank you for your response. I’m a little leery about nerve decompression because of some cases where the results did not last and/or there were complications. Of course complications can happen with any invasive procedure. I do like the idea that the stimulator can be removed in an absolute worst case scenario. I’m likely going to do the stimulator trial and if effective, then figure out my next steps. I will also plan on seeing Dr. Amirlak about nerve decompression to see what is best for me.

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    • By rosie.smiles

      You’re welcome. 🙂 I know one size does not fit all and nerve decompression is not necessarily the answer for all migraine sufferers. I think it’s a good idea to look into both options and see what the experts say (of course most specialists or other medical people will promote their own methods or procedures…naturally). Does insurance cover the Omega procedure? Nerve decompression surgery is sometimes covered, but mine wasn’t (it was worth it though). Whatever the case, I hope you get relief! I know chronic migraine is a miserable existence.

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  • By Nancy Harris Bonk Moderator

    Hi paultxrn and rosie.smiles

    Thank you for sharing your stories and comments. A word about surgery for migraine – these may work for some people, which is great, but seeing as most of us have more than one trigger, we’re likely to continue to have attacks unless we are vigilant about trigger identification and management.

    Here is an article from 2014 about nerve decompression surgery that may help; https://migraine.com/blog/migraine-trigger-site-deactivation-surgery-studies-not-convincing/.

    Best of luck,
    Nancy

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  • By Nancy Harris Bonk Moderator

    Hi paultxrn and rosie.smiles

    Thank you for sharing your stories and comments. A word about surgery for migraine – these may work for some people, which is great, but seeing as most of us have more than one trigger, we’re likely to continue to have attacks unless we are vigilant about trigger identification and management.

    Here is an article from 2014 about nerve decompression surgery that may help; https://migraine.com/blog/migraine-trigger-site-deactivation-surgery-studies-not-convincing/.

    Best of luck,
    Nancy

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    • By rosie.smiles

      Hello Nancy,

      Interesting thoughts…but I want to point out that even though I did have more than one trigger for my migraines (as you said is the case with most people with migraines) before the surgery, I am migraine free. I am eating foods now that seemed to give me migraines before the surgery. I don’t get migraines even when I am sorely lacking on sleep or my sleep schedule is messed up (unlike before surgery). I can drive in the sun or at night and it doesn’t trigger migraines (those were issues for me before surgery). Even things that I can’t control, like the weather which was a problem for me before, aren’t problematic for me now.

      My neurologist had never heard about migraine surgery before I asked him about it (but he was open to it since he and basically all specialists had pretty much given up on finding an answer for me since I had tried *everything* and was still sick and miserable all the time)…but I went ahead and got the surgery since we felt it was the right thing. I had a follow-up appointment with my neurologist after the surgery and he was extremely impressed. He said he might have to start sending more people to this surgeon, since he can see that I am so happy to be feeling *so* much better and the surgery really changed my life. He’s the kind of doctor that sincerely wants his patients to get better and so since the surgery works for so many migraine sufferers, he is open to it and may even promote it, since he has his patients’ best interest in mind. (He won’t keep patients on preventative meds that aren’t working or aren’t worth the side effects, just to keep them coming back so he gets easy payments for an office visit.)

      From the article you mentioned: “While a placebo response may seem better than no response at all, they don’t tend to last.” — then you could say that those who have been permanently helped by the surgery did not have a placebo response? I personally know someone that had nerve decompression surgery years ago and she is still doing extremely well. She is permanently helped so we could say that likely was not a placebo response. They have found that this surgery has lasting results: https://www.sciencedaily.com/releases/2009/10/091025091142.htm

      Although this may not be the answer for all migraine sufferers (I do not think that one size fits all), I certainly don’t think it’s fair to bash nerve decompression surgery (or even strongly discourage people from getting it done) when it could potentially be a life-changer for migraine sufferers like I was…sick, miserable, out of less-invasive options, and nearly out of hope. I just want people to have hope and feel better.

      ~rosie.smiles

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  • By Nancy Harris Bonk Moderator

    Hi Rosie,

    Excellent points, thank you for sharing them with me. As you said surgery may not be for everyone, but for those who get relief, that’s good news.

    Take good care,
    Nancy

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    • By rosie.smiles

      Thanks, Nancy… I’m just so happy about what the surgery did for me and enthusiastic about what it could possibly do for others…but I think we all agree that one size does not fit all in migraine treatment. If another procedure or medication works for others, then that’s great too. 🙂

      Thanks for all you do!
      ~Rosie

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  • By picklestheyorkie

    My wife was dealing with severe debilitating migraines for 30 years and failed nerve decompression surgery as well. We took her to see a wonderful neurosurgeon, Dr. Jeffrey Brown, in Long Island, NY. With the help of a high-resolution MRI, he found bilateral compression of the Trigeminal and Facial Nerves. Although this is an unusual presentation of trigeminal nerve compression, Dr. Brown performed a microvascular decompression (MVD) surgery, normally performed on those with facial neuralgias. Although this surgery is more difficult than peripheral nerve decompression (it is brain surgery), I would highly recommend patients consider this option (and at least speak with Dr. Brown), especially if you have nowhere else to turn. Dr. Brown is recommended by Johns Hopkins migraine hospital when they have tried everything. My wife has been doing well, is off all medication, and has her life back after many years of constant unwavering pain. I’d be happy to chat more if anyone is interested or has questions.

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