The Surgical Treatment for Migraine: A Systematic Review of the Contemporary Literature

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偏頭痛的手術治療：當代文獻的系統回顧林馥郁鄭旭棠

國立台灣大學附設醫院神經部中國醫藥大學附設醫院外科部

Fu-Yu Lin¹, Hsu-Tang Cheng²

1Department of Neurology, National Taiwan University Hospital ²Department of Surgery, China Medical University Hospital

Objective The study was a systemic review of contemporary literature (2000-2011)

to evaluate the surgical treatment for migraine.

Methods There was a comprehensive search of 3 major medical indices (Pubmed,

MEDLINE, Cochrane Library). Selected articles were sorted to identify those related to the surgical treatment for migraine. Extracted data included the number of patients, surgical procedure, follow-up period, response rate and reported complications. The response rate was considered at least 50 percent reduction in migraine headache frequency, duration and/or intensity. A quality assessment of individual studies was performed using established criteria for systemic review.

Results A total of 7 studies met the inclusion criteria. There was only one

randomized controlled trial. The reported response rate of surgical treatment for migraine in these studies varied from 46% to 95% over the follow-up intervals ranging from 6 months to 5 years. Procedure complications were rarely reported.

Conclusions A number of surgical approaches have demonstrated beneficial effects

for selected patients with migraine. Most of these reports, however, are based on small numbers of patients, use non-standardized or inconsistent measurement techniques, and lack of long-term follow-up. The proposed benefits of any surgical intervention should be evaluated in the context of the potential morbidity to the individual patient and the availability of surgical expertise. In addition, although these surgical techniques have shown promising results, nearly all note that the procedures do not obviate the need for continued use of conventional therapies, including medications, for long-term maintenance.

論文分類：H 頭痛及疼痛學通訊作者：林馥郁

連絡地址：台北市

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所屬醫院：台大醫院神經部