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Putting Those Migraines in the Rearview Mirror

A relatively new outpatient surgical procedure available at UT Southwestern is proving effective at reducing or eliminating pain from migraine and chronic headaches, providing a longterm alternative to the short-term relief offered by Botox and other medications.

Called nerve decompression surgery, the procedure involves severing tiny muscles and other tissues pressing on and irritating headache-triggering nerves. There are four general areas - forehead, temples, sinuses, and back of the head and neck - that can be addressed either together or separately.

Each procedure takes about 90 minutes, and incisions are hidden beneath the forehead hairline and behind the nape of the neck. “The results are long-lasting, with 80 to 90 percent of patients experiencing a significant benefit from the procedure,” says Bardia Amirlak, M.D., an Assistant Professor of Plastic Surgery who specializes in peripheral nerve surgery and is one of only a handful of doctors in the country who perform the procedure. “In 50 to 60 percent of cases, the headaches are completely eliminated.”

The majority of migraine and headache patients are candidates for the procedure, he adds. Most people who opt for it have not responded well to other treatments or they have experienced significant side effects from medication. Careful patient selection with the help of a neurologist is important, he notes.

“I’ve seen how this procedure is changing lives,” Dr. Amirlak says. “For people who are suffering from migraine or chronic headaches and not finding relief, nerve decompression could be the answer.”