What Else Can Be Done For My Refractory Migraine Headaches?

Q: Dr. Eppley, have had surgery for migranes the first one was 2012 all four trigger points and deviated septum. about 4 months later I developed a very suttle yet painfull pressure pain in my right temple. It was relentless. feb 2013 the surgeon went back in and removed an artery. for a week I was sure it was better then it came back again. since then I have had steroid injection and anestetic injected in the temple.. no help then botox injected.for two days after I felt great accually thought I might have a life. then the pain came back and remains and it sometimes triggers a full blown migrane, yesterday I got a shot for a migrane I was given demerol toradol and benadryl and phenigan. It helped in all areas but not in the area in the temple I still had the pain.. I cant live like this. the surgeron removed a portion of the zygomatic nerve.

A: Based on your description it sounds like you have had every migraine surgery approach for your right temporal migraines. The zygomaticotemporal nerve has been avulsed and the anterior branch of the temporal artery has been ligated/removed. Short of a temporalis fasciectomy, there are not other surgical options that I know. The fact that Botox had little to no sustained effect does not bode well that any further surgical manipulation would have a high chance of being effective.

Dr. Barry Eppley

Indianapolis, Indiana