Fat injection tames recalcitrant migraine

  • Guyuron B & al.
  • Plast Reconstr Surg
  • 1 Mar 2019

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Fat injection at specific sites on the head brought at least some relief to most patients with medication- and surgery-refractory migraine in this study.
  • The authors include an algorithm for determining when to use this novel procedure.

Why this matters

  • An expert discussion and video are included with this report.
  • The authors have no clear explanation for why fat injection has an effect, but they posit a role for stem cells in fat.

Key results

  • Of the 29 women in the study:
    • 41.4% experienced complete pain resolution.
    • 17.2% had subtherapeutic improvement.
    • 13.8% worsened.
  • For those who improved, mean improvement at last follow-up was:
    • 39.3% fewer migraine attacks in a month (P=.035);
    • 42.0% reduced pain intensity (P=.001);
    • 74.4% shorter attacks (P=.219, not significant);
    • 52.8% reduced migraine index score (P=.012).

Study design

  • Prospective cohort study, 29 women with refractory migraine.
  • Fat injections (sites included occipital, frontal) given September 2012 to January 2015, with at least 1 year of follow-up.
  • Funding: None disclosed.

Limitations

  • Small sample, not randomized.