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Factors associated with poor outcomes in migraine surgery

Hongyang Pi, BS. Edward Nahabet, BS. Bahman Guyuron, MD
University Hospital Case Medical Center
2015-03-15

Presenter: Hongyang Pi

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.

Director Name: Bahman Guyuron

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial

Background
Studies have shown that migraine surgery can result in significant improvement or elimination of migraine headache (MH) in almost 90% of patients. Patient selection, correct detection of trigger sites and complete decompression are key factors in obtaining positive outcomes. The aim of this study is to explore other factors that may be associated with the failure of this procedure.
Methods
A retrospective review of patients operated on by the senior author was conducted. Pre- and post-operative migraine frequency, duration, and severity were reviewed. Patients that experienced no subjective change or subjective worsening in these parameters were included in the study. Demographic data, surgery site, pre- and post-operative migraine questionnaires and medications were analyzed for any statistically significant associations with poor outcomes in migraine surgery.
Results
A total of 14 patients met our inclusion criteria. These patients experienced an average increase in MH frequency of 2.14 MH/month (p-value = 0.14), average increase in duration of 0.2 days (p-value = 0.47), and an average decrease in severity of 0.357 (p-value = 0.19). 4 (29%) patients also had MH pain from a new trigger site. In regards to medications, 3/14 patients had prescribed narcotics and 3 separate patients took prescribed barbiturates; 2 began taking anti-depressants post-operatively.
Conclusion
In patients with a subjective unfavorable response to migraine surgery we determined that there is no statistically significant changes in pre- and post-operative MH frequency, duration or severity. Therefore, we conclude that statistically there is no significant worsening of symptoms.

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