The Positive and Negative Predictive Value of Targeted Diagnostic Botox Injection in Nerve Decompression Migraine Surgery.
Plast Reconstr Surg
; 2023 Jun 06.
Article
em En
| MEDLINE
| ID: mdl-37285182
ABSTRACT
INTRODUCTION:
Nerve decompression surgery is an effective treatment modality for patients who suffer from migraines. Botulinum toxin type A (BOTOX) injections have been traditionally used as a method to identify trigger sites, however there is a paucity in data regarding its diagnostic efficacy. The goal of this study was to assess the diagnostic capacity of BOTOX in successfully identifying migraine trigger sites and predicting surgical success.METHODS:
A sensitivity analysis was performed on all patients receiving BOTOX for migraine trigger site localization followed by a surgical decompression of affected peripheral nerves. Positive and negative predictive values were calculated.RESULTS:
A total of 40 patients met our inclusion criteria and underwent targeted diagnostic BOTOX injection followed by a peripheral nerve deactivation surgery with at least three months follow-up. Patients with successful BOTOX injections (defined as at least 50% improvement in Migraine Headache Index (MHI) scores post injection) had significantly higher average reduction in migraine intensity (56.7% vs 25.8%; p=0.020, respectively), frequency (78.1% vs 46.8%; p=0.018, respectively), and MHI (89.7% vs 49.2%; p=0.016, respectively) post-surgical deactivation. Sensitivity analysis shows that the use of BOTOX injection as a diagnostic modality for migraine headaches has a sensitivity of 56.7% and a specificity of 80.0%. The positive predictive value is 89.5% and the negative predictive value is 38.1%.CONCLUSION:
Diagnostic targeted BOTOX injections have a very high positive predictive value. It is therefore a useful diagnostic modality that can help identify migraine trigger sites and improve pre-operative patient selection.
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Base de dados:
MEDLINE
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article