The Real-World Evaluation of Remote Electrical Neuromodulation in Pediatric Migraines: A Preliminary Study

Background/Objectives: Pediatric migraine disrupts school performance and daily functioning. Concerns about medication overuse and limited efficacy highlight the need for non-pharmacologic treatments. The Nerivio remote electrical neuromodulation (REN) device, which is FDA-cleared for ages 8 and above, was evaluated in this study to assess real-world perceptions among patients in a pediatric neurology clinic. Methods: Patients aged 10-18 years who had used both acute medications and Nerivio completed two structured questionnaires, one reflecting on experiences with acute medication and one reflecting on experiences with acute REN treatment, assessing school and daily functioning, headache control, medication use, satisfaction, and preference. Descriptive statistics summarized the responses. Results: Twenty-four patients participated (91.7% female, mostly aged 13-18 years). Primary outcomes: Nerivio stopped headaches in 33.3% of patients and shortened them in 50.0%, with 41.7% reporting reduced medication use. Exploratory functional outcomes: Missed full school days were unchanged (3.8), partial absences decreased slightly (3.1 to 3.0, ~3%), limited-activity days declined from 3.5 to 2.7 (23%), and days with <50% functioning fell from 4.1 to 3.2 (22%). Preference favored Nerivio in 37.5%, medications in 20.8%, and both equally in 41.7%. Most patients (83.3%) wished to continue; 12.5% reported only mild, transient discomfort, and all continued treatment. Conclusions: This preliminary real-world study suggests that REN is feasible and beneficial in pediatric headache care. Primary outcomes demonstrated meaningful headache improvement, while exploratory measures suggested functional gains. REN reduced acute medication use and achieved high satisfaction, supporting its potential role as a patient-centered adjunct in pediatric headache management. Larger studies are needed to confirm these findings.