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Cefaly External Neurostimulation Device for Preventing & Aborting Migraine Attacks

Cefaly, an electrical nerve stimulation device that is worn like a headband across the forehead and stimulates the nerves through the skin, is my latest experiment in preventing and aborting migraines. There’s a ton of information to share, so I’m breaking it up into several posts, starting with the basics. If you can’t wait to read about the study, here’s Medscape’s writeup: Neurostimulation Effective in Migraine Prevention. (You can get a login from Bugmenot.)

First off, what the heck is Cefaly? It is basically a TENS unit with an electrode shaped to cover the peripheral branches of the trigeminal nerves in the forehead. Instead of being able to adjust the settings freely as you do on a TENS unit, Cefaly is pre-programmed with three therapeutic settings, one for aborting migraine attacks, one for preventing them, and one for relaxation.

According to Cefaly’s website,

Cefaly treats migraine pain with neurostimulation. A stimulus that limits pain signals from the nerve centre by working on the trigeminal nerve where migraine headaches start. The patented Cefaly treatment changes the trigger threshold of migraine headaches. As the pain threshold becomes harder to reach, migraine headaches are less frequent, less painful, and simply disappear. Cefaly offers patients suffering from migraine pain and headaches an efficient electrotherapeutical system delivered via an extremely comfortable, ergonomic and simple-to-use medical device.

An easy-to-follow marketing video:

Harder to follow without knowledge of scientific terms, this video provides a high-level explanation of the science behind the device:

While the marketing materials focus on migraine (and that’s what my experience represents), the manual recommends its use for tension-type headache, cluster headache, and trigeminal neuralgia. It also claims to reduce stress, promote relaxation, and ease the symptoms of sinusitis, though it does not treat the underlying sinus infection.

Cefaly has not been approved for sale in the US and is is not available here. It is available in Canada, Australia, and Europe. I ordered mine from Costco Canada for $230 USD and had it shipped to a friend in Canada who sent it on to me, though I’m not sure this is strictly legal. My headache specialist said his US patients have ordered it directly from Roxon.ca for $299 USD and Oximetry.ca for $340 USD. Although not inexpensive, $230 is reasonable considering the cost of various preventive and abortive meds.

Replacement electrodes come out to $10 each when shipping is factored in. The life of electrodes is listed at 10 uses in the manual, though reviewers on Costco.ca list various strategies for extending their usefulness. I wash my hands and forehead well before applying the electrode and store it in a Ziploc bag with a cotton ball soaked in alcohol next to it. At 11 uses, my original electrode still seems to be working fine. Even if it costs $1 in electrodes each time I use it, that’s still a savings over what I pay for triptans.

There’s enough hype about Cefaly on the internet that I wouldn’t have even tried it had by headache specialist not recommended it. It just seems too good to be true. At the time I saw my headache specialist in May, he had suggested it to 20 of his patients with intractable chronic migraine and half reported at least some relief from it. One had just written him a letter saying the results were close to miraculous for her. Because I trust my headache specialist immensely, I went for it.

Writing this post, I discovered that headache specialist Alexander Mauskop questions whether Cefaly provides advantages over readily available $50 TENS units. While I could have done with saving some money, I derive comfort from the pre-set programs and am not sure if I could have found the right therapeutic settings on my own. If you already have a TENS unit, it might be worth trying it out on your forehead!

I’m still sorting out the kinks and it is too early to establish any preventive effect, but the device has definitely aborted migraine attacks for me. In Monday’s post, I’ll detail my first week with it.

17 Responses to Cefaly External Neurostimulation Device for Preventing & Aborting Migraine Attacks

  1. Nilofer says:

    This sounds very promising. It would be so nice to have an alternative to triptans.

  2. Ben says:

    I’ve tried what is essentially the internal version of this (metal lead implanted under the skin). Unfortunately it didn’t help me, but I hope you’ve had better progress.

    Treatments like this tend to work (unsurprisingly) for headaches that are caused or exacerbated by neuralgia. So, if this helps, there might be a decent chance other neuralgia-type treatments might help, like nerve blocks, Botox injections, massage, biofeedback, etc.

  3. Scott says:

    I am very VERY interested in doing a trial of this, but their website will not sell to me as I am in America. Does anyone know when, or HOW I can order this??? If push comes to shove I can find someone in Canada to cross ship it to me, but that’s another headache I just dont need.

    I am tired of missing work (so is my boss) as well as needing to take enough medication that would kill a fair sized elephant. I have lived with this for ten years (since I was 22 years old) and I just want to be a somewhat normal person again.

    If anyone has any information at all about obtaining it in the USA please email me or respond to this post! I emailed the company since I couldn’t get through their 1-800 number due to being in the USA.

  4. Katherine says:

    Has anyone had any experience with the three-mode version of Cefaly? If so, how has it worked for you? Thanks.

    • I tried the three mode and any review you find online from before April 2014 will be of the three-mode version (though there aren’t many reviews). If you’re looking for less power, like in the three-mode’s “relaxation” setting, you can stop the single-mode early in the program.

      Kerrie

  5. Amy says:

    Is the 3 mode version that much better than the us version.

    I just bought the US version without knowing there was a difference & now I have buyers remorse:(

  6. Rachael says:

    Does anyone know the difference between the 3 setting Canadian version vs the 1 setting us version? I’m trying to decide if the 3 setting version would be more beneficial. Thanks

    • Vee Johnson says:

      I don’t see that much of a difference, and have used both settings 1 and 2 when I have a migraine – both seem very helpful. They ease the pain, and have actually aborted the migraine half the time. The 3 setting version gives you an option at the end to continue the program at full intensity, without the 12 minute buildup – I find this option excellent, and have run the program 2 or 3 times to abort a migraine. I’m not sure if the U.S. version has this option.

  7. Ashbet says:

    I have had trigeminal neuralgia since 2008 (and chronic migraines since 1989), and have been in enough daily facial pain and intractable migraine pain (they last for 2-11 days — the TN pain seems to set them off) that I’m taking sumatriptan, Sprix (nasal-spray ketorolac), and oxymorphone to deal with it — and, even so, it’s still disabling, in terms of my number of functional days per month.

    My new neurologist suggested that I try Cefaly, because he had a unit in his office available for a trial. During the treatment, a nurse came in to check on me, and I automatically smiled in response — and didn’t get the familiar jolt of pain going through my jaw hinge. I was actually at *zero* facial pain for about an hour during/after the treatment, which I have not felt in many years.

    The effects of the treatment, surprisingly, lasted for 9 days — my facial pain stayed down around a 1-2 for most of that time (it usually is at a 3-4, spiking to 6-7 on and off throughout the day), and I had *zero* migraines during that time period — again, it had been years since I went more than 3 days without one.

    Needless to say, I bought a Cefaly unit (through Costco.ca, had a friend in Canada ship it to me), and thus far have been getting good results — when I’ve had a treatment, the TN pain seems to be more transient (and doesn’t tend to keep ramping up throughout the day), and I have fewer and less severe migraines.

    I’m just now getting started on using it for 20 minutes a day as recommended (took a while to get it shipped, due to some unavoidable scheduling issues on my friend’s part — in the meanwhile, my neurologist let me use his unit in the office a couple of times.) Will report back on the efficacy — but I will say that the initial treatment (which I’d had some reservations about — I was afraid that the trigeminal-nerve stimulation would exacerbate my neuralgia) was nothing short of miraculous.

    Not a word I’d use easily, btw — but I have tried every drug therapy imaginable for this pain, including sphenopalatine nerve blocks (and have been turned down by several neurosurgeons as a bad candidate for surgery or an implanted spinal stimulator, because I have an underlying connective-tissue disorder, Ehlers-Danlos Syndrome), and NOTHING gave me this kind of relief.

    It can be purchased in the US, but I wanted the 3-setting device that has a migraine treatment setting, as well as the US-approved ‘prevention’ setting. I have gotten some unclear information on whether devices *currently* sold in the US have one setting or three, and have queried the manufacturer directly — waiting on a response.

    Good luck to all of you!

  8. Sandra Buckenham says:

    I use it – it is fantastic. It takes some getting used to – at first the muscle stimulation feels very strong. Later you learn to relax those muscles and keep your eyes closed.

    It’s most effective when used early in a migraine and for people with ocular migraines. When my headache is well established I find the stimulation is a nice distraction but I need my usual meds/sleep.

    I am now taking it with me when I travel, and I find I use it in a meditAtive way to wind down and fall asleep. I often find it on my husbands forhead and he is sound asleep and snoring.

    • Sandra, I’m so happy it helps you! Thanks for the suggestion to relax your muscles and close your eyes. I’m not sure I tried that. Do you use it preventively or just when a migraine is in the early stages?

      Take care,
      Kerrie

  9. Kristinr says:

    I was having migraines several days a week. There were no meds I could take and my neurologist wanted to start me on botox treatments. As excited as I am to not have forehead wrinkles, I want to happy about being reliant long term on injections. I decided to try cefaly first. I have the single setting one. I have had it about a month and use it several times a week. I’m supposed to use it every day but I forget sometimes. But still, I have only had v two migraines which were much milder and went away within hours. The sensation of cefaly is strange but once I adjusted, I find the sessions very relaxing.

  10. Sid says:

    22 y/o F- I have had a constant 24/7 headache for 29 months. It is clear I have some form of dysautonomia but no doctors have come up with a real diagnosis, nor have any of their “tools” helped even 1%.

    I used the Canadian Cefaly one year ago, hoping to get headache relief. Instead, it started 24/7 tinnitus that has NOT gone away since then. There are moments during every day in which the tinnitus bothers me than the headache. It’s that bad. Obviously the device stimulated my nerve(s) TOO much, and now I am paying the very tragic price. I only used it on the abortive setting, for a few times a day for a few days. I wonder what would happen if I tried it on the relaxation mode? I haven’t used the device since last year and am very worried it could make it worse, but knowing that electricity/stimulation caused my tinnitus and not a loud noise, I wonder if it could be reversible through the same device?

    Any advice or support much appreciated.

  11. Joan Cuthbert says:

    My son’s Neurologist, recommend he try thr Cefaly. He is 31. Johnny has Mosaic Down Syndrome. 7 years ago he started having Grand Mal Seizures, that started a lot of medical problems for him. The seizures triggered Migraines everyday. He has tried all kinds of medication and 2 rounds of Botox Injections, nothing worked. I would like to know if I can buy the Cefaly from Canada. I was thinking that 3 settings would be better, to get him use to the feel of the device. Johnny gets nervous trying new things. I don’t know why they didn’t make it the same for patient in the U.S. Please if someone could give us the information, I would be grateful.

  12. Lori Lobell says:

    For those of us with the one-setting device, could someone tell us what are the other settings, how long do they go, and what is the difference from the one 20 minute prevention setting? Thanks very much.

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