Transcranial Magnetic Stimulation for Migraines

1) What are Migraines?

Migraines are a very common headache disorder affecting about 15% of adults. They often start at puberty and worsen in middle age. Migraines are one of the leading cause of disability in the United States. The first description of migraines was written on papyrus in Egypt 3500 years ago, so migraines are here to stay.  It is probably caused by combination of genetic and environmental factors. Migraines are more common in people with depression, anxiety and bipolar disorder. Migraines are a specific type of headache which is severe and often involves physical symptoms which vary from person to person and with the phase of a headache.

2) What are the 3 phases of a Migraine? 

There are three phases of migraines,  although not all patients have every phase. There's a Prodrome phase, a Pain or Attack phase and a Postdrome phase.  
       The Prodrome phase  occurs in roughly 6 out of 10 migraineurs.  It can occur hours or days before the Pain phase and often includes fatigue, irritability, depression, craving and hypersensitivity to smell or sound. Many people experience an Aura during this phase. It often lasts 5 to 60 minutes and has sensory and visual symptoms. The most frequent sensory problems are alterations in peoples' field of vision,blurred vision, seeing  zigzag lines or losing part of their vision.  About 1/3 of the patients with Auras experience numbness and tingling among other physical symptoms.                   

     The Pain phase is usually a one-sided, throbbing headache. The term "migraine" comes from the Greek word for "pain in half of the head " or "Hemicrania",  hence, the English term Migraine.  Migraines can also be bilateral or on the top or back of the head. People can have a migraine attacks several times a week or once in their lifetime.  About one migraine a month is average but it still causes disabling symptoms. The pain is often associated with light and sound sensitivity, nausea and vomiting.  Some people have an Aura with visual disturbances but no pain.  These are known as "silent migraines". 

     The Postdrome phase follows the Pain phase. During the Postdrome phase people can either feel really good or they can have tenderness at the sight of the migraine and complain of fatigue in cognitive difficulties.

3) Is TMS an option for treating migraines?

     If you suffer from migraines and have failed medication and have avoided environmental triggers like chocolate, alcohol, cheese or MSG (mono-sodium glutamate), you may be a candidate for treatment with TMS (Transcranial Magnetic Stimulation).   A TMS device has been FDA approved for treating acute migraines since 2017 and for migraine prevention since 2014. This is a handheld device that produces magnetic pulses that cross the scalp and skull transcranially to stimulate nerves in various parts of the brain to reduce the severity of migraines. The hand held device is held over the Occipital (back ) part of the head and delivers a mild magnetic impulse. It is not the same device offered by Houston West TMS.

     At Houston West TMS we offer Brainsway Deep TMS.  It is much more powerful and has been shown to be successful in reducing  migraines and improving the patient's quality of life.  Some individuals can get off migraine medication and reduce the drug related side effects.

     One study in 2021 showed TMS was effective in preventing migraines (with or without aura) in 15 to 55  year old patients. TMS also reduced brain inflammation as shown by a reduction in the serum levels of Neurokinin-A, an inflammatory biomarker. Studies have shown TMS reduces migraine severity and duration by reducing pain pathways in the brain and inhibiting "cortical spreading depression" which helps stop the migraine and aura.

     A  review of the numerous studies of TMS for migraines have suggested it is a viable option for treating migraine patients. All of the reviews suggest more studies would be helpful to delineate which types of migraine patients respond to which protocol.  Brainsway Deep TMS has not been FDA approved for migraines yet but is an off label option for people suffering from debilitating migraines.  Unfortunately insurance will not cover the treatments at this time.

4) Does Houston West Tms offered treatment for migraines?

     If you suffer from migraines and are disappointed iwith your current medication options, contact Dr. Drell at Houston West TMS. He offers TMS to compliment or possibly replace your current treatment. options.  Dr. Drell  offers competitive rates to make the TMS treatments as affordable as possible.  Please call 713-464-4455 if you have any questions or want to set up a consultation.

William Drell, MD Houston West TMS and the COVID-19 Pandemic: Our practice is continually monitoring the CDC Guidelines and recommendations from Brainsway and will adjust precautions as necessary to ensure the safety of our patients. We are enforcing recommended Social Distancing s for patients and staff throughout our office and waiting room. Our TMS device is being thoroughly disinfected between sessions, with special attention being paid to surfaces that come into direct contact with patients or operators including the helmet and chair. We are also regularly disinfecting commonly touched surfaces including door handles, light switches and countertops, etc. The office building has implemented extra deep cleaning and more frequent cleansing of bathrooms and water fountains. Any patients who are experiencing symptoms of fever, cough or shortness of breath or who have been exposed to someone diagnosed with COVID-19 should notify our staff before coming in for their TMS treatment so we can decide the treatment options.

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