An Amazing Future Migraine Surgery?

Although this surgery isn’t likely to cure thousands more or completely change the landscape of migraine treatment, it is actually pretty amazing.

It’s actually a new way of doing something that we’ve been able to do for decades – and longer. Let me explain.

Migraine surgery tends to be a more drastic solution for people with chronic migraine who don’t respond well to the many other non-surgical and even non-drug solutions that are available. One of these surgeries involves actually decapacitating nerves that seem to be communicating your headache pain. There are several different ways to do this.

Now, when you think of surgery, you probably think of cutting open skin or cutting through bone. Today, we have some amazing “minimally invasive” surgeries, where surgeons can accomplish amazing things through only a small incision in the skin.

Take for example “pulsed radiofrequency ablation” (PRA). Pulsed radiofrequency treatments for pain started to replace an older method in the 1990s, because it was less invasive. In this surgery for migraine, a probe is inserted through the skin, and radio waves create heat, which basically burns a nerve. If this nerve is involved in transmitting headache pain – simply, it will no longer be able to do its job. For many patients (though not all), this can mean significant headache relief.

This relief is usually temporary, because the nerves usually regenerate. But it is relief that can last for months. So for some patients, this minimally invasive procedure can be a life-changer. (Read more about radiofrequency ablation for migraine here.)

There are other surgical methods that affect the nerves, but the new one that’s being investigated now is called pulsed focused ultrasound (PFU). And here’s the amazing part – no incision is needed to use this treatment. Like “magic”, it can decapacitate the nerves from outside the body, without inserting a probe, and without damaging the skin, or other parts of the body on the way to its target.

You’ve heard of ultrasound. It has many uses, including taking those amazing 3D images of unborn babies, so that Dad and Mom can discuss who the little gal or guy looks like. As you know, we want to be very gentle with Mom and baby, and ultrasound waves are perfect because they’re not damaging tissue.

But ultrasound can do more than take pictures. If there are more focused waves, it can do what PRA does – and disable a nerve. So here’s what happens – (harmless) waves come from various directions, passing through the tissue. They can meet at a precise location (the nerve), and affect only that nerve, and nothing else.

PFU is already being used for Parkinson’s Tremor. In this case, it’s focused on specific areas of the brain – again, an amazing breakthrough, because it can pass through other parts of the brain and focus on one tiny precise area.

This type of surgery may have applications beyond nerves. Could “brain surgery” be used to treat migraine, and other pain conditions?

This isn’t a treatment you’ll be able to use in the near future. But it is amazing to see the treatments that are being developed to treat a number of conditions – treatments that only a few years ago would truly seem like “magic”.