Chapter 5, Episode 6: Neuromodulation Devices for Migraine Treatment

This content has been medically reviewed by Andrea D. Murphy, MSN, APRN, ANP-BC, NEA-BC, AQH

Neuromodulation devices apply external electrical or magnetic impulses to reduce, eliminate or prevent migraine attacks. They are worn or held against different parts of the body to stimulate nerves or areas of the brain and nervous system involved in the migraine process.

This video outlines five neuromodulation devices cleared by the FDA for migraine treatment:

Cefaly, an external trigeminal nerve stimulator, is cleared for the acute treatment of migraine with or without aura and the preventive treatment of migraine with or without aura in people aged 18 or older.1 The device mounts onto an electrode that is attached to the forehead with a sticky backing to stimulate the first branch of the trigeminal nerve.1 

Relivion MG, an External Combined Occipital Trigeminal Neurostimulator is cleared for acute migraine treatment in adults.2 It is worn around the head to target the trigeminal and occipital nerves.2

Savi Dual, a transcranial magnetic nerve stimulator, is cleared for acute and preventive use in people aged 12 and older.3 The device is held against the back of the head to deliver non-invasive, painless, pulses.3

GammaCore, a non-invasive vagus nerve stimulator, is cleared for acute and preventive use in people aged 12 and older.4 The device is held against the side of the neck to stimulate the vagus nerve.4

Nerivio, a remote electrical neuromodulation device, is cleared for acute and preventive use in people aged 12 and older.5 It is worn on the upper arm to stimulate pain fibers responsible for sending messages to the pain regulation centers in the brain.5

All devices except for the external trigeminal nerve stimulator require a prescription. The devices are typically paired with a smartphone app to adjust impulse levels, track usage, and generate reports for your provider.

Neuromodulation devices may be especially useful for people with multiple comorbidities, with sensitivity to medications or their side effects, with or at risk for medication overuse headache, or those who prefer to avoid medications.

However, they are not safe for everyone. Some devices are contraindicated for people with epilepsy, an implanted device or a history of stroke. Special considerations apply based on the device therefore it is important to discuss your medical history and device precautions with your provider. 

General side effects that may occur are lightheadedness, dizziness, numbness, tingling, site tenderness, headache and more. Some people may find the sensations uncomfortable or painful. For the devices that also have a preventive indication, each individual is unique and there may be an adjustment period where the frequency and duration of treatment may slowly be increased for better tolerability. 

Currently, there is not enough information to know if the devices are safe during pregnancy or breastfeeding. 

Overall, neuromodulation devices offer a drug-free treatment option. They may be used in combination with other treatments or as the only option. Talk to your healthcare provider to see if neuromodulation could be right for you.

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*The contents of this video are intended for general informational purposes only and does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. AMD does not recommend or endorse any treatment, products, or procedures mentioned. Reliance on any information provided by this content is solely at your own risk.