AMSTERDAM (Dispatches)-In addition to reducing headache frequency and severity, surgical treatment for migraine leads to significant improvements in everyday functioning and coping ability, according to a new study.
Surgery has become recognized as an effective treatment option for selected patients with chronic, severe migraine headaches who do not respond to standard treatments. Developed by plastic surgeons who noticed that some migraine patients had fewer headaches after cosmetic forehead-lift, migraine surgery procedures address trigger sites linked to certain headache patterns.
However, most studies evaluating migraine surgery have relied on migraine-specific questionnaires. "Pain questionnaires used in the evaluation of better-understood and more common pain syndromes have not been applied to migraine surgery," American Society of Plastic Surgeons (ASPS) member Surgeon William Gerald Austen, Jr, of Massachusetts General Hospital says.
The study evaluated the performance of one such questionnaire -- the Pain Self Efficacy Questionnaire (PSEQ) -- in migraine surgery patients. The PSEQ has been used to study treatment outcomes in patients with a wide range of pain conditions. It provides information not only on pain scores, but also on functional disability and ability to cope with pain when performing normal daily activities.
Before migraine surgery, the patients had "extremely poor" PSEQ scores, indicating a high level of disability. Preoperative pain coping scores in migraine patients were substantially lower than reported for patients with other types of chronic pain -- for example, neuropathic (related to nerve damage) pain, arthritis, or lower back pain.
One year after migraine surgery, the patients had a very large percent improvement in average PSEQ score: on average, 112 percent higher than baseline. That was much higher than in studies of patients with other types of chronic pain: for example, an average 19 percent improvement after nonsurgical treatment for low back pain.