( back to school to get a second degree ...)A Combination of Botox and Surgery Cures Migraines,Health

back to school to get a second degree, something I could never have considered before."

Dr. Janis said: "Many neurologists are using Botox to treat migraines, but they are making the injections in a 'headband-like' circle around the forehead, temple and skull.

They are not looking at finding the specific location of the headache's trigger point. While patients may get temporary relief, after the Botox wears off they will have to go back and get more injections or continue medications for migraines.

"It's like a math equation. I will inject the Botox into one trigger point at a time and leave the others alone. The Botox is used as a diagnostic test to determine what trigger point is causing the problem. If patients get a benefit from the Botox, they likely will get a benefit from the surgery. If there's no benefit from the Botox, then there won't be a benefit from the surgery."

Dr. Janis began collaborating more than five years ago with Dr. Bahman Guyuron, a plastic surgeon at Case Western Reserve University and the first to explore using surgery to relieve migraines, following the revelation by several of his patients that their migraines had disappeared after they had cosmetic brow lifts.

Dr. Janis has assisted his colleague by performing anatomical studies on cadavers to explore the nerves and pathways that might cause migraines. Together they have identified four specific trigger points and developed a treatment algorithm that includes using Botox prior to deciding whether to perform surgery.

During the past several years, numerous peer-reviewed articles have been published in Plastic & Reconstructive Surgery detailing their research efforts and the researchers have presented the technique at professional meetings of plastic surgeons.

Approximately 28 million Americans, 75 percent of those women, suffer from migraines, according to the National Institutes of Health. For employers
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