Permanent Fix to Chronic Migraines?

Playing Surgery for Man with Debilitating and Chronic Migraines

The following material contains graphic images of an actual surgery that may be disturbing. Parents are advised that these images may not be suitable for young children.

More than 37 million Americans suffer from migraines and for some, the symptoms can be debilitating. This was the case for Ronny, who shares his story with The Doctors, as well as brings them inside the operating room for his life-changing peripheral nerve surgery.

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Ronny had been suffering from migraines since the age of 14. The pain would come from the back of his neck and then spread to the front of his forehead and into his eyes and temples. This was coupled with extreme nausea and vomiting. His migraines left him bedridden and unable to work. 

Ronny tried all sorts of medications and therapies like acupressure and massage. He also tried lifestyle changes, stress management, diet and exercise, yet nothing stopped the migraines. He saw over 15 doctors and dentists and he almost gave up hope. Then, he met plastic and peripheral nerve surgeon Dr. Ziv Peled.

Dr. Peled explains the most common misconception about migraines is that they are caused by an abnormality inside the brain. Sometimes, they are caused by the compression of nerves outside of the brain, caused by scar tissue, spastic muscle, or abnormal blood vessels. This was the case for Ronny.

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Dr. Peled operated on Ronny to release the nerves from the back of his head and from the spastic muscles. The Doctors watch as Dr. Peled operates on Ronny to remove the nerves that are causing the pain in the front and temples.

A few weeks post-operation, Ronny and Dr. Peled join The Doctors in the studio. Ronny shares he is almost one hundred percent pain-free! Plastic surgeon Dr. Andrew Ordon asks Dr. Peled what made Ronny a good candidate for this peripheral nerve surgery.

Dr. Peled says the ideal candidate has:

  1. Been diagnosed with migraines by a board-certified neurologist or headache specialist
  2. Failed conventional therapies including various drugs and injections
  3. A good physical exam that shows there’s a peripheral nerve that is causing the headaches
  4. Responded well to an injection of a numbing agent or a local anesthetic in the office. For example, their headache goes from 9 to 1 on the pain scale.

The numbing in the office allows the doctor to identify the nerves that are causing the problem in question as well as gives the patients the ability to test drive their results, and see what numbness they may have if any nerves are cut.

Ronny shares he was fearful before the surgery of having his nerves cut but the pain was so terrible he had no choice. He says he hasn’t had any noticeable side effects and while he has a little numbness behind his ear and in his forehead, he never notices or thinks about it!  

If you are a migraine sufferer and want to know if this surgery is an option for you, there are four criteria for finding the right surgeon:

  1. Someone with specific training in peripheral nerve surgery during either a residency or fellowship. Someone who has done nerve surgery not just in the head and neck but all over the body
  2. Someone with specific training in this headache operation 
  3. Someone who could provide patient references, ideally from several years out, to show the results are lasting
  4. You can use the American Society for Peripheral Nerve to look for members

Dr. Peled shares that Medicare does cover this set of operations but unfortunately, not all payers do because it is still relatively new. He recommends discussing insurance with your surgeon so they can help you navigate the landscape and if it’s not covered, give you an idea of the costs. 

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