Efficacy of Temporal Migraine Headache Surgical Deactivation in Elimination of Triggers and Associated Symptoms (Site II)

Purpose:

The objective of this study is to examine the effect of surgical deactivation of temporal (site II) triggered migraine headaches (TMH) on migraine triggers and associated symptoms.

Methods:

Charts of 235 patients receiving surgery for TMH by a single surgeon over a 10-year period who were followed at least 1 year were analyzed. Median regression adjusted for age, sex, and follow-up time was used to determine post-operative reduction in temporal-specific Migraine Headache Index (TMHI), which is the product of frequency, severity, and duration. The association between individual symptom or trigger resolution and TMHI reduction was studied by logistic regression.

Results:

Benefit of site II surgery includes significant (p<0.01) reduction of TMHI from the pre- to post-operative period regardless of age, sex, and follow-up time. Symptoms resolving with successful site II surgery include nausea (p<0.05), photophobia and phonophobia  (p<0.05), difficulty concentrating (p<0.05), vomiting (p<0.05), blurry vision (p<0.05), and eyelid ptosis (p<0.05). Triggers resolving with successful site II surgery include letdown after stress (p<0.05), air travel (p<0.05), missed meals (p<0.05), bright lights (p<0.05), loud noises (p<0.05), fatigue (p<0.05), weather change (p<0.05), and certain smells (p<0.05).

Conclusions:

Surgical deactivation of TMH is effective regardless of age, sex, or follow-up time. Successful site II surgery is associated with changes in specific symptoms and triggers. This information can assist in trigger avoidance and contribute to constellations used for TMH trigger-site identification.