Prospective evaluation of outcomes in migraine surgery patients at the Massachusetts General Hospital
Lisa Gfrerer, MD PhD1, Heather R. Faulkner, MD MPH2, William G. Austen, Jr., MD MPH2.
1Harvard Medical School, Boston, MA, USA, 2Massachusetts General Hospital, Boston, MA, USA.
Several groups have shown positive responses to migraine surgery in 68-95% of cases. However, most studies have analyzed data retrospectively. Few groups have presented prospective outcomes. We present the first prospective data at the Massachusetts General Hospital.
40 patients were prospectively enrolled and asked to complete information on demographics, past medical history, past migraine history and to answer following questionnaires: Migraine headache index [MHI- frequency (days) x duration (fraction of 24hours) x average pain severity (on a scale of 0-10)], Headache impact test (HIT6), and pain self efficacy questionnaire (PSEQ). Results were analyzed after a 12-month follow-up.
Mean MHI, HIT6 and PSEQ scores changed significantly from preop to postop (see Table 1). Interestingly, there was no difference between 3 and 12-month results. The mean MHI improvement was 78% at 3 months and 88% at 12 months. At 12 months, the MHI in 30 (80%) of patients improved >80%, 6 (15%) improved between 50-80% and 2 (5%) improved <50%. There were no major adverse events.
Results in our prospective series are comparable to our retrospective results, further supporting the safety and efficacy of migraine surgery as a treatment option for migraine sufferers. No significant difference in outcomes between 3 and 12 months suggests that results can be predicted at 12 weeks.
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