Neuromodulation and Non-Pharmacological Treatment of Migraine
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.
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 or its receptor among other drugs.
Some other drugs are under investigation and the CGRP receptor antagonists,
were discontinued although other drugs in this category are still under investigation.
However, there are some medically intractable headaches or unsatisfactory patient
management or medications are poorly tolerated, therefore, additional treatment options might be helpful.
A number of nonpharmacological methods such as education, reassurance, avoiding
the triggers of migraine, and physical and/or complementary medicine when appropriate, have
also been recommended in the treatment of migraine and other headaches.
Dietary modifications and lifestyle changes have also been suggested.
Other methods such as physical therapy with relaxation and thermal biofeedback
have also been used in the treatment of migraine.
Neuromodulation and Non-Pharmacological Treatment of Migraine.
Neuro Open J. 2016; 3(1): e5-e10. doi: 10.17140/NOJ-3-e006