Dr. Mathew once more considers the fact that the patients were not followed up by an independent neurologist a flaw. Again, to expect an independent neurologist to follow the surgical patients for

5 years and to collect data is totally unreasonable. This is not what is done in the surgical field and, again, I wonder how often it is done in the neurology field. I sincerely hope that this type of distrust is not ubiquitous in the neurology field. We trust and respect our colleagues in the surgery field who devote their lives to research and believe in the scientific integrity of the researchers unless it is proven otherwise. Dr. Mathew writes, “Among the 79 patients who presented at the 5-year follow-up, selleck screening library 10 received additional learn more procedures. These 10 subjects were not included in the final analysis. It is interesting to note that these 10 patients had ‘significant improvement’ of their migraines but still opted to proceed with additional procedures. One could assume that these patients had an outcome that would negatively impact the final results, and not surprisingly, these 10 subjects were not included in the final analysis.” I find this blatant claim offensive and this is the first time that the integrity of what I do has been questioned by anyone. I am not sure why he did not notice or chose to ignore our clear statement in the

article that the final results were analyzed with and without inclusion of those 10 subjects and there was no statistically significant difference in the final outcome. Those patients who had additional surgery had a significant improvement in the sites where they had the surgery, Amisulpride but they still had residual pain in the non-operated sites and that is why they underwent additional surgery.

We were trying to render them pain free by operating on the sites that we had not touched previously. It would have been unfair and totally selfish to deny them additional improvement for 4 more years because of the fact that we needed them to continue having some pain to prove a point to the unfair skeptics. These patients had already served in the initial 1-year phase of the study. Additionally, I wonder how Dr. Mathew would have judged our study had we included the 10 patients who had undergone additional surgery. Would he not have claimed that the study was seriously flawed since some patients underwent additional procedures? Furthermore, had there been any hint of dishonesty in our report, we would not have mentioned anything about the second surgery, since the surgery was not being repeated on the same site. However, this type of disclosure and exclusion of patients who had undergone additional surgery is an obligation of any research team with integrity and should not be used against the researchers. Dr.