title: Emerging therapies for chronic migraine.
abstract: Not all chronic migraines are medication-overuse headaches and so the challenge is how to treat them. Currently available pharmacological therapies may be ineffective or they are abandoned because of intolerable side effects. There is still much room for novel therapeutic approaches in those with drug refractory migraine (RM). Occipital nerve stimulation (ONS) and botulinum toxin type A have finally gained a level of evidence based on the results of RCTs and pooled analysis, which by and large have shown at least a modest but valuable therapeutic effect. For a long time, these two approaches were only supported by clinical experience and open-label studies. Considering the disabling nature of migraine disorder, the large prevalence and serious impact on health-related quality of life and health care costs, any degree of response to treatment is acceptable and welcomed by the patient. An important issues for future studies would be better patient selection when finding candidates for each procedure.
authors: Headache Centre - Neuromodulation Unit, National Neurological Institute IRCCS "C.Besta" Foundation, Via Celoria, 11, 27100, Milano, Italy, proietti.a@istituto-besta.it.
authors: Alberto
authors: A
authors: Proietti Cecchini
authors: Licia
authors: L
authors: Grazzi
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002908:Chronic Disease; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy / Q000628:therapy*; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D009778:Occipital Lobe / Q000503:physiopathology; D010353:Patient Education as Topic; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A