Drug-Free Devices for Modulating Migraine

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Key Questions
  • What are neuromodulation devices and how do they work?
  • How many neuromodulation devices for migraine are currently on the market?
  • Are there safety concerns and side effects with these devices?
  • Is the process for FDA clearance of these devices as rigorous as that of medications?
  • Are neuromodulation devices approved for both chronic and episodic migraine?
  • Should these devices be used acutely, preventively, or both?
  • Do all of these devices require a prescription?
  • How much do these devices cost?
  • Are they readily available in both the U.S. and abroad?
  • Does insurance cover neuromodulation devices?
  • Are these devices safe for adolescents?
  • How do we know which of these devices is appropriate for us and our type of migraine?
  • Are any of these devices appropriate for cluster headache?
  • Are these devices painful to use?
  • Is there anyone who should avoid using these devices?
  • Is it realistic to expect that neuromodulation devices can abort migraine attacks?
  • When is the best time to use a device?
  • Why aren’t these devices prescribed more frequently?
  • Are there more devices on the way?
Interview Notes

Find more about Deena Kuruvilla and her work here:

  • Device availability, insurance coverage, and price may change. Check the manufacturer’s website in your country.
Treatments Mentioned
  • Cefaly (eTNS-external trigeminal nerve stimulation device)
  • eNeura (sTMS-single pulse transcranial magnetic stimulator)
  • gammaCore device (nVNS-noninvasive vagal nerve stimulation device)
  • Nerivio (REN-remote electrical neuromodulation device)
  • Relivion (trigeminal and occipital nerve stimulation device)
Updates and Corrections 
  • gammaCore is now FDA-cleared for acute and preventive treatment in episodic and chronic migraine. See the manufacturer’s website for the latest price information in your area, which has reportedly improved since this interview was filmed.
  • Relivion began entering the US market in the fall of 2021 through a limited market release, with broader access in 2022. It is reported to be available in Europe.

Please note: The Migraine World Summit’s aim is to bring you a variety of perspectives and expertise, independent of bias or judgment. Alternative theories presented in this video have not been medically reviewed. Views expressed in this interview do not necessarily represent the views of the Migraine World Summit. Please always consult your health care professional and do your own research before making changes to your treatment plan.

Deena Kuruvilla, MD, FAHS

Neurologist & Director
Westport Headache Institute

Dr. Kuruvilla is a board-certified neurologist and director of the Westport Headache Institute, where she employs a holistic, biopsychosocial approach to diagnosis and treatment. She is also certified in headache medicine by the United Council for Neurologic Subspecialties. She is an assistant professor adjunct at the Yale School of Medicine, and has authored many articles, book chapters, and research publications. Her practice focuses on treatment procedures for headache, such as nerve-block injections, botulinum toxin injections, and trigger-point injections.

She is a member of the American Academy of Neurology and the American Headache Society, and actively serves on the Procedural Headache Medicine Special Interest Section of the American Headache Society. She has also been an invited reviewer and author for many peer-reviewed publications, including Headache, Cephalalgia, JAMA, and the British Medical Journal.

Dr. Kuruvilla’s research and clinical work has been widely featured in the press, including Prevention magazine, Neurology Today, the Hartford Courant, and The Wall Street Journal.

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Migraine & Headache Australia is the only organization in Australia that has supported the more than 5 million Australians affected by headache and migraine for 20 years. Migraine & Headache Australia is a division of the Brain Foundation.

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