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Emerging therapies for chronic migraine
Alberto Proietti Cecchini1, Licia Grazzi
1Headache Centre - Neuromodulation Unit, National Neurological Institute IRCCS "C.Besta" Foundation, Via Celoria, 11, 27100, Milano, Italy, proietti.a@istituto-besta.it.
Current Pain and Headache Reports
|February 14, 2014
Summary
Treating chronic migraines not caused by medication overuse presents challenges. Occipital nerve stimulation and botulinum toxin offer modest benefits for refractory migraine patients.
Area of Science:
- Neurology
- Pain Medicine
Background:
- Chronic migraines pose treatment challenges, especially when not medication-overuse headaches.
- Existing pharmacological therapies can be ineffective or poorly tolerated, necessitating novel approaches for drug-refractory migraine (RM).
Purpose of the Study:
- To review the evidence for occipital nerve stimulation (ONS) and botulinum toxin type A in treating refractory migraine.
- To highlight the therapeutic value and limitations of these interventions.
Main Methods:
- Review of randomized controlled trials (RCTs) and pooled analyses for ONS and botulinum toxin type A.
- Consideration of prior clinical experience and open-label studies.
Main Results:
- Both ONS and botulinum toxin type A have demonstrated modest but valuable therapeutic effects in refractory migraine.
- These interventions are now supported by a growing body of evidence beyond initial clinical observations.
Conclusions:
- Occipital nerve stimulation and botulinum toxin type A represent important therapeutic options for patients with drug-refractory migraine.
- Future research should focus on optimizing patient selection for these procedures to maximize treatment efficacy.
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