Institute for Plastic Surgery 
Phone: 217-545-6314
Fax: 217-545-2588
E-mail: plastics@siumed.edu 
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SIU Healthcare Migraine Surgery Clinic

Welcome to the SIU Healthcare Migraine Surgery Clinic within the Institute for Plastic Surgery.   For anyone who has suffered from chronic migraine headaches or who has watched a loved one suffer, you know how painful, debilitating and disruptive they can be.  We are very pleased to be able to offer a proven successful surgical option for the treatment of chronic migraine headaches for patients who have had inadequate response to medications intended to prevent or stop migraines.

Initial Phone Consultation & Evaluation

Prospective patients are contacted by phone by our Patient Coordinator. She will conduct an initial 20-minute pre-screening consultation to determine if you meet the criteria for further evaluation for migraine surgery.

Criteria:

If you meet the criteria our patient coordinator will:

Note: Your first appointment will be scheduled 5 to 6 weeks out because you will be required to complete a 4-week consecutive tracking diary of your migraines before your initial office visit. This allows time for mailing your patient package and for completing and submitting your 4-week diary prior to being evaluated by Dr. Sommer.

Initial Visit

Bethany Tschantz, CNPYour medical history and Migraine Headache Diary will be reviewed by the patient coordinator and Dr. Sommer. 
Dr. Sommer will conduct a focused physical exam and, if you are determined to be a candidate for migraine surgery, you will be given Botox® injections by Dr. Sommer in the migraine trigger zone(s) identified if insurance authorization has been given.
You will then be scheduled for a follow-up appointment in 12 weeks. Please note that it takes about one week for the Botox® to be effective. During this time, you will be asked again to record your migraines in your migraine headache diary for a period of 8 weeks beginning one week following the Botox® injections.

Post-Botox® Injection Visit

This is the most important visit in deciding whether or not a patient qualifies for surgery. During this visit the post-Botox diary will be reviewed and compared to your initial pre- Botox diary. There are 3 possible results from the Botox® injection:

Migraine Surgery Treatment

Migraine surgery is performed under general anesthesia and is typically done on an out-patient basis. On the average, surgery takes approximately 1.5 hours per zone that is surgically treated.

What We Need from You

Follow instructions for completing all required forms as indicated in the patient package that will be mailed to you. In order to give all our patients the best care possible all forms must be filled out and returned prior to your visit.
The 4-week diary of your migraine headaches is extremely important information for Dr. Sommer to review and analyze so that your migraine trigger zone can be accurately identified. This information becomes the basis of the treatment plan that Dr. Sommer will recommend for you and needs to be returned as instructed prior to your appointment with Dr. Sommer for planning purposes.

Migraine Trigger Zones

Migraine headaches may be triggered by irritation of nerve endings in well delineated areas of the head and neck. The irritation of these nerve endings may eventually lead to a migraine attack. These nerve endings are located in 4 defined zones. Botox® injections can be used to identify 3 of the zones; specifically the frontal, temporal and occipital migraine zones. Positive Botox® responders are considered to be candidates for migraine surgery. It is important to note that some patients suffer from migraines involving more than one zone. Dr. Sommer will determine which zone(s) are appropriate to address with migraine surgery. For the frontal, temporal and occipital zones, surgical candidates are those who respond positively to Botox® injections of the specific zones.

Defining Characteristics--4 Common Migraine Trigger Sites:

1. Frontal Zone Migraines

2. Temporal Zone Migraines

3. Occipital Zone Migraines

4. Nasal Zone (also called Rhinogenic) Migraines

Migraine surgery has been demonstrated to provide a complete cure in 35% of patients who respond to Botox®. However, more than 90% of properly selected "Botox® Responders" dramatically improve after migraine surgery with reported decrease in frequency, severity and duration of the migraines. Migraine surgery takes the pressure off the irritated nerves, making the patient more resistant to triggering factors which raises the threshold for developing a migraine attack.