Choosing Wisely:

Don’t recommend surgical deactivation of migraine trigger points outside of a clinical trial.

Rationale and Comments: The value of this form of “migraine surgery” is still a research question. Observational studies and a small controlled trial suggest possible benefit. However, large multicenter, randomized controlled trials with long-term follow-up are needed to provide accurate estimates of the effectiveness and harms of surgery. Long-term side effects are unknown but potentially a concern.
Sponsoring Organizations:
  • American Headache Society
  • Sources:
  • Expert consensus
  • Disciplines:
  • Neurologic
  • References: • Guyuron B, Kriegler JS, Davis J, Amini SB. Comprehensive surgical treatment of migraine headaches. Plast Reconstr Surg. 2005;115:1-9.
    • Guyuron B, Reed D, Kriegler JS, Davis J, Pashmini N, Amini S. A placebo-controlled surgical trial of the treatment of migraine headaches. Plast Reconstr Surg. 2009;124:461-8.
    • Guyuron B, Kriegler JS, Davis J, Amini SB. Five-year outcome of surgical treatment of migraine headaches. Plast Reconstr Surg. 2011;127:603-8.
    • American Headache Society urges caution in using any surgical intervention in migraine treatment. Position statement of the American Headache Society [Internet]. Mount Royal (NJ): American Headache Society; 2012 April 13 [cited 11 January 2013] Available from: www.americanheadachesociety.org/american_headache_society_urges_caution_in_using_any_surgical_intervention_in_migraine_treatment.

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