Surgery for migraines is a relatively new treatment option for patients suffering with severe migraines and is showing some very promising results! Dr Lambru runs a large MDT (multidisciplinary team meeting) for the surgical treatment of migraines. This meeting brings together top migraine specialists to discuss patients who may be suitable for these surgical options for migraine.

The surgical treatments for migraine include:

• Occipital nerve stimulation
• Cervical spinal cord stimulation

Traditionally surgery has been a process whereby you change the structure of the body for example if you have appendicitis you remove the appendix, so you are removing or altering the anatomy. However, the surgery for migraines is fundamentally different because it doesn’t alter the structure of the tissue, just the function. Migraine surgery is a little more like medicine than surgery. If you take a drug you don’t alter the structure of the body but you do alter its function. For example, you can take a drug and it corrects the abnormal function of a specific part of the body. Migraine surgery sits at the borderline between traditional structural changing surgery and medicine. However, rather than using a drug the human function, brain or nervous tissue is altered using electricity rather than chemicals (which is how the drugs work). It is a fundamentally different way of doing things than standard surgery.

This could be changing the function of the brain which is the ultimate neural structure, changing the function of the spinal cord, the cranial nerves and the peripheral nerves. Spinal cord stimulation uses electricity to alter the function of the spinal cord. Occipital nerve stimulation uses electricity to change the functioning of the occipital nerve.

These stimulations use electricity to change the function of the nerves and tissues to reduce pain, correct abnormal function and alter the behaviour of these tissues. This involves placing electrodes into the tissues and a battery into the body. These batteries generate electricity to deliver different types and intensities of electricity by altering the current, the voltage, the pulse width or the frequency. The clever bit here is the battery that can be programmed to deliver all sorts of different combinations of electricity to alter and correct function. The electrodes transmit this electricity to the point of interest in the brain, the spinal cord and the nerves.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.