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Experimental Surgery Being Used to Treat Migraines

By
WebMD Health News
Reviewed by Gary D. Vogin, MD

March 19, 2002 -- Millions who suffer from recurrent migraines know all too well how painful and disabling the headaches can be. Victims are often forced to retreat to darkened bedrooms due to extreme sensitivity to light and sound. Throbbing pain is often accompanied by nausea or vomiting, and symptoms can last for days.

Migraine therapy has made great strides in recent years, with the approval of a host of new drugs to both prevent and treat the headaches. But a surgical approach to migraine management has remained elusive. Now a neurosurgeon in Syria says he has developed a simple, effective, outpatient surgery that can cure patients with migraines. Experts remain skeptical, but neurosurgeon Ali M. Sultaneh, PhD, says he has used the technique effectively on more than 1,000 patients.

And Sultaneh says migraine patients can test his theory, and get relief from their headaches at the same time, by simply applying pressure to the pulse just in front of their ears for several minutes. Several migraine sufferers writing to a WebMD message board did just that, and agreed that it did offer relief.

"For the last 20 hours I feel like a human being again," one reader wrote. Another wrote that," My 10-day-old migraine diminished rapidly and finally disappeared in about 45 minutes."

Sultaneh tells WebMD that he stumbled on the migraine surgery while treating patients with headaches associated with brain and facial tumors. Once he began doing research into vascular headaches like migraines, he developed the controversial theory that arteries outside the skull, known as extracranial arteries, are responsible for these headaches. His surgical approach involves placing the patient under local anesthesia, making a small vertical incision and sewing shut several of these extracranial arteries. The surgeon claims there are no side effects to closing off these arteries, which supply blood to the hair and scalp.

The technique was presented at a meeting of the American Association of Neurological Surgeons in San Diego last year, but several peer-reviewed medical journals have refused to publish Sultaneh's findings. Syria's medical establishment has also criticized his work, and Sultaneh says he now performs the operation on his own, with no outside backing.

"[Syrian medical officials] told many lies about my work," he says. "They said that my operation causes loss of hair and skin [death]. But it is not true and they know that. If they had even one patient that said this happened, I would stop doing this operation."

But migraine expert Seymour Diamond, MD, says Sultaneh's surgery is probably no more effective than a host of other surgical approaches that have been tried over the years. He adds that the neurosurgeon has provided no follow-up on the patients who have had the surgery, so it is not clear how safe and effective it is. Diamond is director of the Diamond Headache Clinic in Chicago.

"We have learned in recent years that migraines occur in the deep blood vessels that surround the brain and within the brain, not on the superficial scalp arteries that [Sultaneh] is talking about," Diamond says. "This dubious surgical approach just doesn't match what we know happens with these headaches."

He says any benefit from the surgery, and from the neurosurgeon's pressure point self-treatment technique, can likely be chalked up to a placebo effect.

"I have been around for a long time, and every so often a neurosurgeon will come along with a fantastic cure," he says. "But there is no surgical cure for migraines."

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