Exeter Headache Clinic

Transcranial Magnetic Stimulation

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Statement by the Exeter Headache Clinic


1. We welcome the development of alternative non-drug treatments for migraine and transcranial magnetic stimulation (TMS) offers an interesting option. 

2.  NICE has stated in a Health Technology Assessment that this intervention can be effective and in the short to medium term is safe. These assessments are for guidance only and do not commit the NHS to providing the treatment.  Decisions will be made by local NHS commissioners (in England NHS  Clinical Commissioning Groups) on the basis of whether they offer value for money or in cases of special circumstances.

3. This intervention is supported by one high quality trial for migraine with aura which showed moderate improvement.  39% of migraineurs were pain free at 2 hours compared with 22% in a comparative group that had a sham or dummy treatment.  There was no difference in migraine related quality of life outcomes in the two groups. The cost of TMS is £150 per month.

4.  Until further high quality evidence is forthcoming, TMS should be considered for the acute treatment of migraine where available acute treatments, used in conjunction with recommended preventative treatments have failed or cannot be taken due to unacceptable side effects or clinical contraindications. It cannot be considered as an alternative to drug therapy.

5.  Further information can be obtained from: 
http://guidance.nice.org.uk/IPG477/Guidance/pdf/English

and for patients:
http://publications.nice.org.uk/treating-and-preventing-migraine-by-magnetic-stimulation-of-the-brain-ifpip477/what-has-nice-said