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Review
. 2015 Sep;16(9):1827-34.
doi: 10.1111/pme.12792. Epub 2015 Jul 14.

Neurostimulation for Treatment of Migraine and Cluster Headache

Todd J Schwedt  1 , Bert Vargas  1
Affiliations
Review

Neurostimulation for Treatment of Migraine and Cluster Headache

Todd J Schwedt et al. Pain Med. 2015 Sep.

Abstract

Objective: The objective of this narrative review is to summarize the current state of neurostimulation therapies for the treatment of migraine and/or cluster.

Methods: For this narrative review, publications were identified by searching PubMed using the search terms "migraine" or "cluster" combined with "vagal nerve stimulation," "transcranial magnetic stimulation," "supraorbital nerve stimulation," "sphenopalatine ganglion stimulation," "occipital nerve stimulation," "deep brain stimulation," "neurostimulation," or "neuromodulation." Publications were chosen based on the quality of data that were provided and their relevance to the chosen topics of interest for this review. Reference lists of chosen articles and the authors' own files were used to identify additional publications. Current clinical trials were identified by searching clinicaltrials.org.

Results and conclusions: Neurostimulation of the vagal nerve, supraorbital nerve, occipital nerve and sphenopalatine ganglion, transcranial magnetic stimulation (TMS), and deep brain stimulation have been investigated for the treatment of migraine and/or cluster. Whereas invasive methods of neurostimulation would be reserved for patients with very severe and treatment refractory migraine or cluster, noninvasive methods of stimulation might serve as useful adjuncts to more conventional therapies. Currently, transcutaneous supraorbital nerve stimulation is FDA approved and commercially available for migraine prevention and TMS is FDA approved for the treatment of migraine with aura. The potential utility of each type of neurostimulation has yet to be completely defined.

Keywords: Cluster Headache; Deep Brain Stimulation; Migraine; Neurostimulation; Occipital Nerve Stimulation; Sphenopalatine Ganglion Stimulation; Transcranial Magnetic Stimulation; Transcutaneous Supraorbital Nerve Stimulation; Vagal Nerve Stimulation.

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Figures

Figure 1
Figure 1. Neurostimulation methods for treatment of migraine and/or cluster
Invasive and non-invasive methods of neurostimulation for treating migraine and/or cluster are illustrated. ONS = occipital nerve stimulation; SONS = supraorbital nerve stimulation; TMS = transcranial magnetic stimulation.
See this image and copyright information in PMC

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