title: Migraine Trigger Site Surgery is All Placebo.
abstract: BACKGROUND
  Over the last decade surgical treatments for migraine involving proposed trigger sites have been described and popularized by plastic surgeons in particular. Various related techniques aim to free up "trigger sites" by removal of small facial muscles or "decompressing" small facial nerves.
  
  
  CONCLUSIONS
  The basis for migraine trigger site surgery is without merit. There is one positive placebo controlled study with many limitations. Natural history and placebo mechanisms explain the outcomes from migraine surgery. The American Headache Society recommends that the migraine surgery not be performed outside of a clinical trial.
  
  
  CONCLUSIONS
  Migraine trigger site surgery should not be performed.
authors.affiliation: Department of Neurology, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA.
authors.forename: Brian E
authors.initials: BE
authors.lastname: McGeeney
mesh_terms: D019299:Decompression, Surgical / Q000379:methods; D005152:Facial Muscles / Q000473:pathology / Q000601:surgery; D006801:Humans; D008881:Migraine Disorders / Q000175:diagnosis* / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D015990:Placebo Effect; D015985:Precipitating Factors
keywords: migraine; migraine surgery; placebo; trigger site