Are Genetics the Predicting Factor for the Success of Migraine Surgery? A Report on Identical Twins
Elisabeth Russe,
Sandra Scharfetter,
Fabian Köninger,
Mark Rinnerthaler,
Gottfried Wechselberger
Affiliations
Elisabeth Russe
Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital of the Brothers of St. John of God, Paracelsus Medical University, 5020, Salzburg, Austria; Corresponding authors Contact Information: Prof. Dr. Elisabeth Russe, MD MBA FEBOPRAS FEBHS, Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital of the Brothers of St. John of God, Paracelsus Medical University, 5020 Salzburg, Austria, Phone: +43 662 8088 8452
Sandra Scharfetter
Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital of the Brothers of St. John of God, Paracelsus Medical University, 5020, Salzburg, Austria
Fabian Köninger
Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital of the Brothers of St. John of God, Paracelsus Medical University, 5020, Salzburg, Austria
Mark Rinnerthaler
Department of Biosciences and Medical Biology, Genetics of Aging, Paris-Lodron University, 5020, Salzburg, Austria
Gottfried Wechselberger
Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital of the Brothers of St. John of God, Paracelsus Medical University, 5020, Salzburg, Austria
Summary: Migraine affects more than 1 billion people globally, with distinct genetic variations influencing susceptibility. Thereby, genetic variations play a key role in the probability of developing migraine. However, personalized genetic analysis-based treatment options in migraine treatments are limited. Notably, surgical deactivation of extracranial trigger has shown efficacy in the treatment of migraine patients with identifiable trigger points in specific anatomical locations in the head and neck region.We present the first case of monozygotic twin sisters, both experiencing occipital and temporal-triggered migraine headaches with identical history and characteristics and without response to conservative migraine treatments. After surgical intervention, targeting the greater and lesser occipital nerves as well as auriculotemporal nerves, both twin sisters exhibited an over 99% reduction in symptoms without postoperative complications. This case suggests a potential correlation between genetic background, irrespective of environmental factors, and the effectiveness of surgical deactivation of trigger points in migraine management.