Facelift a cure for migraines?

HOUSTON

For Maryann Niese, just playing outside with her grandchildren carried the risk of crippling pain -- from migraine headaches.

"It was so bad that I was vomiting, had to go home, and the light hurt my eyes," she said.

But after decades of seeing neurologists for her migraines, Niese decided to turn to a plastic surgeon instead, pinning her hopes on a procedure that originally evolved from a common type of face lift.

"We're not really particularly sure why it works; we just know that it does work," Dr. Thomas McNemar said.

Dr. Thomas McNemar began by freezing so-called "trigger points" around Niese's eyes and temple with Botox, to test the effect. Niese reported temporary relief, making her a candidate for the surgery.

The procedure uses techniques similar to an endoscopic brow lift, which involves severing muscles and raising the eyebrows. But instead of changing Niese's look, Dr. McNemar says the migraine surgery is designed to relieve muscle pressure on nerves that can trigger the headaches.

"I was having 12 to 15 a month," Niese said. "Now I've had 3 to 4 -- that's the most I've had since the surgery."

Still, some experts are skeptical of the technique, pointing out that other surgical strategies have been tried for migraine in the past.

Neurologist Peter Goadsby says many migraine patients -- particularly women -- experience relief in late middle age. Niese is 63.

"The natural history of migraine is to get worse up until the 40's and 50's, then go away or get better, particularly because of menopause," Dr. Goadsby said.

Still, supporters point to a recent study published in the Journal of Plastic and Reconstructive Surgery, in which eight out of 10 patients in the trial reported relief. And they say the results are encouraging enough to support continued research.

The procedure is not cheap. It can range from about $3,000 to $10,000 dollars, and in most cases, it is not covered by insurance.