Neuromodulation and Non-Pharmacological Treatment of Migraine

Abstract

Migraine is a chronic brain disorder that is believed to be due to dysfunction of the
brain and brainstem that result in dysmodulation of sensory processing of the head and vascular
tone. The exact pathomechanism of migraine is not known but some genes including mutations
in the sodium and calcium channels and Na+/K+ pump have been implicated in migraine with
aura.1-8
Several drugs are currently used in the acute and preventive treatment of migraine.
These include the non-steroidal anti-inflammatory drugs, the triptan family, anti-epileptic
drugs, beta-blockers, calcium channel blockers, steroids, and recently antibodies against calcitonin
gene-related peptide (CGRP) or its receptor among other drugs.5,9 Some other drugs are
under investigation and the CGRP receptor antagonists (the gepant family drugs), were discontinued
although other drugs in this category are still under investigation.10-16 However, there are
some medically intractable headaches or unsatisfactory patient management or medications are