Surgical treatment of migraine relies on neurolysis (that is, release of the nerve) of the different branches of the trigeminal nerve.

The various nerve branches exit the facial bones through foramina. At these sites, the nerve can be compressed, triggering an attack. Botulinum toxin, by reducing the contraction of the muscles surrounding these foramina, reduces the pressure on the nerve and thus helps to decrease or even eliminate migraine attacks.

To free the nerves that exit at the level of the superior orbital rim (around the eyebrow), Dr. Zirak makes a small incision that will become invisible later, in the eyelid crease.

The nerve located there will not be damaged or cut by the operation. Thus, the patient regains the skin sensation of the forehead after an initial period of numbness.

The same procedure is used to treat the nerve branch that exits below the inferior orbital rim (below the lower eyelid) as well as in the temple or neck region.

It is therefore crucial that we determine, with the patient, the point that is most often implicated in the onset of migraine attacks.

This information is collected through highly precise questionnaires as well as two botulinum toxin injection tests.

Among thousands of patients treated with migraine surgery, we have 80% good results, including 35% of patients who had no migraine symptoms even one year after the operation; for the remaining 65%, the frequency of attacks and the intensity of pain had decreased by more than half.