Published December 20, 2016 By Adam Lowenstein


Because of the relatively new ability for surgeons such as myself to impact migraine headaches and occipital neuralgia with outpatient surgery, we often get the question of whether nerve decompression for headache surgery is “experimental surgery.”  Let me assure you that this is not the case.  While scientific descriptions of success rates can be found in peer reviewed literature with references listed below, these studies show that release of nerves in the forehead, temple, and occipital (posterior) regions of the head and neck have an excellent chance of alleviating if not eliminating pain.  In 2005, Dr. Guyuron reported that 82 of 89 patients (92%) of followup patients experienced elimination or significant improvement in their headache symptoms at over a year from surgery.  This improvement persisted in 88% of follow up patients from that group in a subsequent publication at 5 years.

In 2009, that same center did a gold standard randomized study where 41 of 49 patients (83.7%) had migraine elimination or significant improvement, with 28 of 49 patients 57% reporting complete elimination of their migraine symptoms.  This was quite significantly different from the control group of patients that did not have nerve decompression.

Experimental surgery is usually thought of as a procedure that is being tried in the course of experimenting to evaluate a success rate.  Those experiments have already been done with regard to headache surgery.  The votes are in.  Though the surgery is relatively new (about 10 years old now) and there are not as many surgeons who are specializing in this as in other more common surgeries, you should feel comfortable in having a properly trained and confident headache surgeon discuss and perform nerve release surgery on you should you qualify as a surgical candidate.

Some references…..

Guyuron B, Kriegler JS, Davis J, et al. Comprehensive surgical treatment of migraine headaches. Plast Reconstr Surg. 2005;115:1–9.

Guyuron B, Kriegler JS, Davis J, et al. Five-year outcome of surgical treatment of migraine headaches. Plast Reconstr Surg. 2011;127:603–608.

Guyuron B, Reed D, Kriegler JS, et al. A placebo-controlled surgical trial of the treatment of migraine headaches. Plast Reconstr Surg. 2009;124:461–468.

Janis JE, Dhanik A, Howard JH. Validation of the peripheral trigger point theory of migraine headaches: single-surgeon experience using botulinum toxin and surgical decompression. Plast Reconstr Surg. 2011;128:123–131.

Poggi JT, Grizzell BE, Helmer SD. Confirmation of surgical decompression to relieve migraine headaches. Plast Reconstr Surg. 2008;122:115–122; discussion 123–124.

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