Plastic Surgery Research Council

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Does Migraine Surgery Affect Medication Use?
Ricardo Ortiz, BSc, Lisa Gfrerer, MD PhD, Marek A. Hansdorfer, MD, Kassandra Nealon, BSc, William G. Austen, Jr., MD.
Massachusetts General Hospital, Boston, MA, USA.

Patients with migraine headaches (MH) suffer debilitating pain that often leads to the use of numerous medications. MH surgery has emerged as an effective treatment in select patients. The aim of this study was to describe preoperative and postoperative medication use among patients undergoing MH surgery.

160 patients undergoing MH surgery between 2013 and 2018 were prospectively enrolled. Information on medication use, including type, dose, and frequency of use was collected. Follow up surveys were sent to all patients twelve months postoperatively.

109 patients met inclusion criteria. Preoperatively, 95% of patients described taking prescription medication for their MH pain. Type of medication varied among patients but included abortive in 46%, preventative in 54%, rescue in 62%, and antiemetic in 18%. At twelve months postoperatively, 64% of patients reported using less prescription medication. Patients reported a 67% decrease in the number of days they took medication (Fig). Twenty percent stopped medications altogether. Fifty-two percent of patients reported that their migraine medication helped them more compared to preoperatively.

MH surgery has been shown to improve symptoms in up to 90% of patients. We now show that it is also associated with a significant decrease in medication use. It is important for surgeons to be aware of this data as we continue to counsel future patients.

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