Theory: What is migraine?.- Myths and Misperception.- Pathophysiology of migraine.- History of migraine surgery.- How does migraine surgery work?. Current scientific evidence.- Interdisciplinary approach. Practice: Course of treatment.- Patient selection.- The Botox test.- PREEMPT vs Decompression.- The surgery (nose, temple, neck, forehead).- Follow-up.- Controversy.- Perspective.
Migraine surgery is the only existing treatment option that can lead to a permanent symptomatic improvement. Surgical techniques and advances in the understanding of the underlying mechanisms are evolving rapidly. This book intends to familiarise surgeons with the concept of migraine headaches and explains the surgical deactivation of trigger sites, which consists of much more than the decompression of pericranial nerves. The traditional notion of the brain as the sole origin of migraine is supplanted by a concept where the alteration of afferent signals in conjunction with peripheral and central sensitization can trigger a migraine attack. Migraine surgery targets the crucial role of extracranial tissues in the genesis of migraine which is corroborated by substantial clinical, anatomical and pathophysiological evidence.
Dr Muehlberger studied medicine and literature in Munich, Berlin and Boston. He completed his surgical training in Oxford and Cambridge, UK, and in Baltimore, USA, and is board-certified in General Surgery and Plastic Surgery. He is an Associate Professor of Plastic Surgery, founded the Migraine-Surgery-Centre (c) and acts as medical director at medsteps,Switzerland.