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A study in the December issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgery (ASPS), reported that patients who underwent surgery for carpal tunnel syndrome and other upper extremity nerve compression syndromes were more likely to be diagnosed with migraine
.
The magazine was published
in Wolters Kluwer's Lippincott collection.
The findings add to previous evidence
that there may be a "co-susceptibility" between migraine and upper extremity nerve compression syndrome, according to ASPS member surgeons Kyle R.
Eberlin, M.
D.
, Lisa Gfrerer, M.
D.
, and colleagues at Massachusetts General Hospital at Harvard Medical School.
Certain types of neurodecompression surgery are associated with higher migraine rates
The researchers analyzed data from nearly 9,600 patients who underwent nerve decompression surgery on the upper extremities (arms, wrists, and hands) between 2009 and 2019, from a large hospital database
.
The most common procedure is median nerve decompression (71% of patients), which is usually used in patients with
carpal tunnel syndrome.
These patients are screened for diagnosis of migraine
.
Patients who receive two upper extremity nerve decompression procedures are more likely to be diagnosed with migraine: median nerve decompression and polyneurosis
.
Overall, 7% of patients who underwent median nerve decompression and 8.
8% who underwent multiple nerve decompression procedures were diagnosed with migraine
.
After adjusting for other risk factors, patients who underwent median nerve decompression were 30% more likely to be diagnosed with migraine than those who underwent ulnar nerve decompression at the elbow and 70%
more likely to be diagnosed with polyneurodecompression.
Patients with migraine should consider nerve compression regimens
In recent years, plastic surgeons have developed migraine surgery techniques to relieve sites of nerve compression, or "trigger points"
associated with migraine attacks.
The researchers believe that patients with wrist nerve compression, such as carpal tunnel syndrome, who are diagnosed with migraine should consider nerve compression as a potential treatment option
.
Building on previous research, the report "provides further evidence of a link between upper extremity nerve compression and migraines," Dr.
Eberlin and colleagues wrote
.
The reported correlation suggests that patients with symptoms associated with nerve compression in the arm and hand may also be susceptible to nerve compression
of migraine-related trigger points.
While it is unclear how many patients diagnosed with migraine also have neurocompression syndrome, "there is likely a biological and genetic overlap between CTS and migraine," concludes Dr.
Eberlin and co-authors
.
They call for further research into common mechanisms
that may explain the link between the two different types of neuroimpingement syndrome.
At the same time, the researchers wrote, "it is important that hand and peripheral neurosurgeons recognize migraine as a comorbid condition in patients with neuroimpingement syndrome and provide comprehensive screening
for both conditions.
"