Roux-en-Y gastric bypass achieves substantial resolution of migraine headache in the severely obese: 9-year experience in 81 patients

Günay, Yusuf; Jamal, Mohammad; Capper, Alyssa; Eid, Anas; Heitshusen, Debi; Samuel, Isaac

doi:10.1016/j.soard.2012.01.009

Cited by 18 publications

(18 citation statements)

References 30 publications

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“…Recently, a retrospective study found that 89% of patients experienced migraine improvement in an averaged of 5.6 months after weight-loss surgery. Moreover, they found that patients, like ours, who developed migraines after the onset of obesity, were more likely to enjoy such results [7]. A smaller prospective study also found migraine reduction following surgery, correlating closely with amount of excess weight loss [8].…”

Section: Discussionsupporting

confidence: 58%

“…At 1-year postsurgery follow-up, our patient continued to report migraines, however not enough time has yet elapsed to declare migraine treatment failure. Gunay and colleagues found that it took up to 36 months for some patients to show headache improvement [7]. Clinicians are reminded that patients may suffer from more than one kind of headache with potentially overlapping symptoms.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of idiopathic intracranial hypertension with gastric bypass surgery

Levin

Hess

Hohler

2014

International Journal of Neuroscience

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Idiopathic intracranial hypertension (IIH) is defined by elevated intracranial pressure and associated headaches, changes in vision and pulsatile tinnitus, among other symptoms. It occurs most frequently in young, obese women. Gastric bypass surgery has been used to treat morbid obesity and its comorbidities, and IIH has recently been considered among these indications. We present a case report of a 29-year-old female with a maximum BMI of 50.3 and a 5-year history of severe headaches and moderate papilledema due to IIH. She also developed migraine headaches. After a waxing and waning course and various medical treatments, the patient underwent laparoscopic Roux-en-Y gastric bypass surgery with anterior repair of hiatal hernia. Dramatic improvement in IIH headaches occurred by 4 months postprocedure and was maintained at 1 year, when she reached her weight plateau with a BMI of 35. Presurgery migraines persisted. This adds to the small number of case reports and retrospective analyses of the successful treatment of IIH with gastric bypass surgery, and brings this data from the surgical literature into the neurological domain. It offers insight into an early time course for symptom resolution, and explores the impact of weight-loss surgery on migraine headaches. This treatment modality should be further investigated prospectively to analyze the rate of headache improvement with weight loss, the amount of weight loss needed for clinical improvement, and the possible correlation with improvement in papilledema.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Treatment of idiopathic intracranial hypertension with gastric bypass surgery

Levin

Hess

Hohler

2014

International Journal of Neuroscience

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“…Limited data in uncontrolled studies suggest that morbidly obese episodic and chronic migraineurs who undergo bariatric surgery have a reduction in monthly frequency and headache severity 3 to 6 months after surgery. [32][33][34][35] In addition, although several well-designed aerobic exercise trials have demonstrated efficacy for reducing headache days and pain severity in those with migraine, it remains unclear as to whether this is related to the exercise itself or as a result of weight loss. 32 We also found that being underweight (BMI , 18.5) was associated with a small increased risk of migraine.…”

Section: Neurology 88 May 9 2017 1801mentioning

confidence: 99%

Body composition status and the risk of migraine

et al. 2017

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Objective: To evaluate the association between migraine and body composition status as estimated based on body mass index and WHO physical status categories.Methods: Systematic electronic database searches were conducted for relevant studies. Two independent reviewers performed data extraction and quality appraisal. Odds ratios (OR) and confidence intervals (CI) were pooled using a random effects model. Significant values, weighted effect sizes, and tests of homogeneity of variance were calculated.Results: A total of 12 studies, encompassing data from 288,981 unique participants, were included. The age-and sex-adjusted pooled risk of migraine in those with obesity was increased by 27% compared with those of normal weight (odds ratio [OR] 1.27; 95% confidence interval [CI] 1.16-1.37, p , 0.001) and remained increased after multivariate adjustments. Although the age-and sex-adjusted pooled migraine risk was increased in overweight individuals (OR 1.08; 95% CI 1.04, 1.12, p , 0.001), significance was lost after multivariate adjustments. The age-and sex-adjusted pooled risk of migraine in underweight individuals was marginally increased by 13% compared with those of normal weight (OR 1.13; 95% CI 1.02, 1.24, p , 0.001) and remained increased after multivariate adjustments. Conclusions:The current body of evidence shows that the risk of migraine is increased in obese and underweight individuals. Studies are needed to confirm whether interventions that modify obesity status decrease the risk of migraine. Both migraine and obesity are conditions associated with substantial personal and societal burdens.1 As obesity is a potentially modifiable risk factor, the relationship between migraine and obesity has been a focus of research interest for the last decade. [1][2][3] Although several studies support that obesity is associated with an increased risk of migraine, results are inconsistent with regards to included populations, how obesity status is categorized, and other features of individual study design and conduct, and the conclusions drawn.

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“…A group of severely obese individuals undergoing a Rouxen-Y gastric bypass experienced a significant reduction in their migraine headaches, but it was unclear whether this related in any way to improvement in sleep apnoea [28]. Likewise, a group of patients with migraine treated with bariatric surgery experienced a decline in their migraine frequency over and above any improvement with CPAP preoperatively in those with OSA [29].…”

Section: Obstructive Sleep Apnoeamentioning

confidence: 99%

Sleep and Chronic Daily Headache

Stark

2014

Curr Pain Headache Rep

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Sleep and headache have a complex and extensive interrelationship. This review focuses on the relationship between sleep and chronic daily headache, examining recent advances in the epidemiology and insights into possible mechanisms of this relationship as well as reviewing advances in treatment. There is a clear relationship between obstructive sleep apnoea (OSA) and snoring and morning headache, but the relationship between OSA and snoring and other primary headaches requires clarification. OSA and chronic migraine share both obesity and patent foramen ovale (PFO) as possible co-morbidities. Hypoxia does not clearly predispose to morning headache. Continuous positive airway pressure (CPAP) is an established treatment for OSA, and mixed results have been reported with regards to headache improvement with this treatment.

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Roux-en-Y gastric bypass achieves substantial resolution of migraine headache in the severely obese: 9-year experience in 81 patients

Cited by 18 publications

References 30 publications

Treatment of idiopathic intracranial hypertension with gastric bypass surgery

Treatment of idiopathic intracranial hypertension with gastric bypass surgery

Body composition status and the risk of migraine

Sleep and Chronic Daily Headache

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