Anatomy of a Headache

Dr. Robbins Free Medical
Radio Podcasts

Long-Acting Opioids for
Refractory Chronic

Study results for a group
of difficult-to-treat
migraineurs provide a
basis for determining
efficacy and guidelines
for the use of long-term
opioids in this


Heatherís Chronic
Migraine: an Interactive
Case History

This column will take you,
step by step, through
the diagnosis of a complex
headache patient with
the pseudonym of "Heather."



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TMS as Acute Migraine Therapy
Lipton, RB
Posted: April 2010
Neurology Update

A recent study published in Neurology Update suggests transcranial magnetic stimulation (TMS) to be a viable therapy for acute migraine. This study, funded by Neuralieve, Inc., included 201 migraine sufferers. Half of the participants were given the portable TMS device, with the other half receiving an identical sham-stimulation device. All were instructed to use the device to treat as many as three episodes of migraine with aura during a three month period, and to initiate treatment as soon as possible and one hour after aura onset.

The primary outcome of the study was the proportion of patients with a pain-free response during the first migraine episode. 39% of the TMS group was pain free at 2 hours, compared to 22% of sham group. Analysis of secondary efficacy endpoints indicated TMS had significantly higher rates of sustained pain-free response at 24 hours (29% vs 16%) and 48 hours (27% vs 13%) post treatment Additionally, TMS users recorded lower rates of photophobia, phonophobia, and nausea than the sham group.

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