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Suggest Treatment For Severe Migraine Headaches

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Posted on Wed, 19 Oct 2016
Question: Good morning! I'm pretty sure I had my vagus nerve severed when I had my rouXY surgery 8 years ago and I'm having severe migraines. I'm wondering possible connection? I had the surgery to treat pseudotumor cerebri. That was cured in four days. This does not feel the same it's not a pressure of spinal fluid. These are just bad headaches everyday.
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Answered by Dr. Dariush Saghafi (2 hours later)
Brief Answer:
Vagal nerve injury related to migraines?

Detailed Answer:
Thank you for your question. If your migraine headaches are of recent origin then, it is highly unlikely that any denervation of the vagus nerves is responsible. Far too much time would've elapsed from the time of your surgery to make any connection possible.

If your headaches began immediately or shortly following your bariatric procedure then, still it is not an automatic connection simply because we do not have any universally accepted theories that there are any direct links between vagal nerve damage whether it be incidental to other surgical procedures or planned as in a vagotomy. Migraine headaches are believed to be initiated and promulgated by the Trigeminal neurovascular complex and this is not under any direct control by the vagus nerve.

There are some studies and cohorts of patients who have demonstrated improvements to their migraine headaches (diagnosed as primary headaches) using methods of VAGAL NERVE STIMULATION using devices and such, however, this does not imply that any LACK of vagal nerve function in the body would automatically trigger the onset or development of migraine headaches.

If your situation of bodyweight or other functions of the GI tract, etc. have not appreciably changed since developing your headaches then, I would suggest a review of your situation by a headache specialist locally who may ask you to start documenting specific parameters of your headaches in what we refer to as a headache log. The log or diary will help the neurologist determine whether or not you are suffering from PRIMARY vs. SECONDARY headaches. If your headaches are determined to be as a result of your surgery in some way then, they would be classified as SECONDARY HEADACHES and their treatment would depend upon the exact cause. If on the other hand, they are PRIMARY in nature such as would be the case with migraines, tension type, clusters, or trigeminal autonomic cephalgias then, treatment could be offered using standard approaches of both medication and other forms of intervention not necessarily related to pharmacological means.

If you've not been seen in a while for your PSEUDOTUMOR CEREBRI (now referred to as IDIOPATHIC INTRACRANIAL HYPERTENSION- IIH) then, it may serve to be seen by a neurologist to make sure that entity either hasn't returned or isn't in some beginning stage of re-occurring.

If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my answers/suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 31 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2473 Questions

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Suggest Treatment For Severe Migraine Headaches

Brief Answer: Vagal nerve injury related to migraines? Detailed Answer: Thank you for your question. If your migraine headaches are of recent origin then, it is highly unlikely that any denervation of the vagus nerves is responsible. Far too much time would've elapsed from the time of your surgery to make any connection possible. If your headaches began immediately or shortly following your bariatric procedure then, still it is not an automatic connection simply because we do not have any universally accepted theories that there are any direct links between vagal nerve damage whether it be incidental to other surgical procedures or planned as in a vagotomy. Migraine headaches are believed to be initiated and promulgated by the Trigeminal neurovascular complex and this is not under any direct control by the vagus nerve. There are some studies and cohorts of patients who have demonstrated improvements to their migraine headaches (diagnosed as primary headaches) using methods of VAGAL NERVE STIMULATION using devices and such, however, this does not imply that any LACK of vagal nerve function in the body would automatically trigger the onset or development of migraine headaches. If your situation of bodyweight or other functions of the GI tract, etc. have not appreciably changed since developing your headaches then, I would suggest a review of your situation by a headache specialist locally who may ask you to start documenting specific parameters of your headaches in what we refer to as a headache log. The log or diary will help the neurologist determine whether or not you are suffering from PRIMARY vs. SECONDARY headaches. If your headaches are determined to be as a result of your surgery in some way then, they would be classified as SECONDARY HEADACHES and their treatment would depend upon the exact cause. If on the other hand, they are PRIMARY in nature such as would be the case with migraines, tension type, clusters, or trigeminal autonomic cephalgias then, treatment could be offered using standard approaches of both medication and other forms of intervention not necessarily related to pharmacological means. If you've not been seen in a while for your PSEUDOTUMOR CEREBRI (now referred to as IDIOPATHIC INTRACRANIAL HYPERTENSION- IIH) then, it may serve to be seen by a neurologist to make sure that entity either hasn't returned or isn't in some beginning stage of re-occurring. If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my answers/suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out. Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. This query has utilized a total of 31 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.