Novel acute and preventive treatments (2)
. Single-pulse transcranial magnetic stimulation – several handheld devices have been approved for the acute migraine therapy. These include The Spring TMS is FDA approved for migraine with aura in patients aged ≥18 years; it should not be used for more than one treatment in 24 hours. GammaCore, a handheld device for acute and preventive migraine therapy, generates an electrical signal to deliver transcutaneous vagal nerve stimulation (VNS). VNS can suppress high glutamate levels in the trigeminal nucleus caudalis, which may be the pain-blocking mechanism of non-invasive VNS.
. Sphenopalatine ganglion stimulation – because of the reported preventive effect in cluster headache, trials are exploring efficacy as means of preventing migraines.