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Thursday 26 June, 2008

The Migraine Surgery Centre

New Clinic to Offer Innovative Approach to Migr...

LONDON, June 27 /PRNewswire/ --

    A new clinic has opened in London today (Friday 27 June 2008), offering
for the first time, a surgical approach to migraine. The Migraine Surgery
Centre brings hope to the six million people in the UK who suffer from
migraine attacks.

    Migraine is a complex condition with a wide variety of symptoms, ranging
from painful headache to disturbed vision. Attacks can last anywhere between
four to 72 hours(1), during which time sufferers often have no choice but to
lie still in a darkened room.

    The surgical approach to migraine was discovered in the USA in the year
2000 in a clinical study involving 314 patients. Surgeons removed the
corrugator muscle, a small muscle around the eyebrow, in order to eliminate
'frown lines'. Prior to the procedure, 39 of the 314 patients had experienced
migraine. One year after surgery, 31 of these 39 patients reported that their
migraine had either disappeared completely or diminished considerably. Since
then, a number of studies have been conducted on the efficacy of operative
migraine therapy(2),(3),(4),(5), which have demonstrated that:

    - 35 per cent of patients experienced complete relief from migraine
      symptoms one year after migraine surgery.
    - In a further 57 per cent of patients, the frequency of the attacks and
      the intensity of the pain were reduced by more than half following the

    The Migraine Procedure is the only approach that doesn't start with the
symptoms but rather the cause of the migraine, and is based on the finding
that many migraine attacks are triggered by an interaction between the
corrugator muscle and the trigeminal nerve, located above the eyebrows. Since
not all migraines are triggered at these points, migraine surgery will not be
suitable for all migraine sufferers, and so the patient selection process is
key to the success of the procedure.

    The Migraine Procedure incorporates a series of defined steps:
    - Patient completes a questionnaire to determine the trigger points for
      their migraine.
    - If it is established that the patient's migraines are likely to be
      triggered by the corrugator muscle, the patient receives an injection 
      of botulinum toxin type A (commonly marketed as Botox), which 
      effectively paralyses the muscle that triggers the migraine attacks.
    - If, after a period of eight weeks, the patient has experienced a
      significant improvement in migraine symptoms following the botulinum
      toxin injection, the patient is offered the surgical procedure, which 
      removes the muscle that triggers the migraine attack.
    - In addition to relief from migraine symptoms, removal of the
      migraine-triggering muscle causes the frown lines situated between the
      eyebrows to soften, and in most cases, to disappear.

    Commenting on the findings of the study, Professor Thomas Muehlberger,
clinical director of the Migraine Surgery Centre said:

    "Over the years, there have been many developments in migraine
treatments, ranging from over the counter pain-killers to prescription drugs.
These treatments provide symptomatic relief, but they do not address the
cause of the migraine and so the attacks occur just as frequently as before.
Although the Migraine Procedure will not be suitable for all patients, it
will offer many of those affected a real chance of freeing themselves from
their migraines completely or at least reducing the severity and frequency of
their attacks".

    Treatment of migraine with botulinum toxin type A has been an established
procedure in the USA for some years and is increasing in popularity in the UK
as well. Paralysis of individual muscles in the forehead and head area by
botulinum toxin type A can deliver relief from migraine symptoms, however,
this relief is only temporary and needs to be repeated once every three
months to have a lasting effect.

    Denise Richardson, originally from London, experienced the effects of the
Migraine Procedure after contacting Professor Muehlberger's Berlin-based
Migraine Centre:

    "About four years ago, it got to the point where I was having headaches
every few days. The pain was virtually unbearable and even strong
prescription painkillers had no effect. After contacting the Migraine Centre,
I was sent a questionnaire to complete. Based on my answers I was assessed as
being a good candidate for the botulinum toxin test that could lead to a
possible procedure. Following the injection, my headaches decreased to about
3 in 8 weeks with a low pain rating; obviously a good indication that
subsequent surgery would be successful. Based on this result, I decided to go

    "The most wonderful thing is that since the operation I have had no
headaches at all. My forehead is tension and line-free and my quality of life
has improved beyond anything I could possibly have imagined. I can now
concentrate better at work and I have the old happy, energetic 'me' back

Notes to Editors

    Migraine Facts
    - Migraine is the most common neurological condition in the developed
      world: it is more prevalent than asthma, epilepsy and diabetes 

    - Migraine is extremely common, affecting 12-28% of people at some point
      in their lives(7)

    - Almost six million people in the UK have migraine, with an estimated
      190,000 migraine attacks occurring every day(8)

    - Over half (54%) of migraineurs experience one or more attacks per
      month, and 13% claim one or more attacks per week(1)

For online information please visit

    Associate Prof. Dr. Thomas Muehlberger studied medicine in Munich, Berlin
and Boston, USA. He completed surgical training at Oxford and Cambridge,
England and underwent plastic surgery training at The Johns Hopkins
University, Baltimore, USA.

    (1) The International Classification of Headache Disorders, 2nd Edition
    (2) Guyuron B, Kriegler JS, Davis J, Amini SB (January 2005).
        Comprehensive surgical treatment of migraine headaches. Plast. 
        Reconstr. Surg. 115 (1): 1-9.

    (3) Bearden WH, Anderson RL. Corrugator superciliaris muscle excision for
        tension and migraine headaches. Ophtal Plast Reconstr Surg 2005; 21: 

    (4) Dirnberger F, Becker K. Surgical treatment of migraine headaches by
        corrugator muscle resection. Plast Reconstr Surg 2004; 114: 652-657

    (5) Guyuron B, Varghai A, Michelow BJ, Thomas T, Davis JR. Corrugator
        supercilii muscle resection and migraine headaches. Plast Reconstr 
        Surg 2000; 106: 429-434

    (6) The Migraine Trust. Factsheet 8. The Facts About Migraine

    (7) Stovner et al. (2006). "Epidemiology of headache in Europe". Eur. J.
        Neurol. 13 (4): 333-45

    (8) Steiner et al, Cephalagia, 2003

LONDON, June 27 /PRNewswire/ --


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