Explore recent migraine treatment research on the following slides.
Scientists are actively exploring novel treatment modalities to help relieve the pain of chronic migraines. Three recent advances approach migraine treatment in three unique ways. First, the FDA has approved the use of a nasal treatment for migraines in a pediatric patient population. Second, patients with migraines may be able to use a non-invasive electrostimulation device to reduce muscle contraction and prevent migraines. Finally, surgeons are able to use Doppler to identify the precise area of most intense pain in patients with migraines and successfully remove the artery associated with the migraine.Â
Zolmitriptan Approved in Adolescents.
• The FDA recently announced the approval of zolmitriptan (ZOMIG) to treat migraine with or without aura in pediatric patients aged 12 to 17 years.
• Migraine is estimated to affect about 6.3% of U.S. children aged 12 to 19, according to the American Migraine Prevalence and Prevention Study.
• Zolmitriptan was found in clinical trials to significantly improve headache pain, relief of headache, and other associated symptoms compared with placebo.
• The FDA has recommended a starting dose of 2.5 mg; however, the dose can be adjusted on an individual basis. The maximum recommended dose is 5 mg with no more than 10 mg taken in a 24-hour period.
• Zolmitriptan is a serotonin (5-HT) 1B/1D receptor agonist that was first approved by the FDA in 2003 for acute treatment of migraine in adults. Source: FDA Approves ZOMIGÂ® (zolmitriptan) Nasal Spray for Migraine in Pediatric Patients (Ages 12-17). 16 June 2015. http://www.prnewswire.com/news-releases/fda-approves-zomig-zolmitriptan-nasal-spray-for-migraine-in-pediatric-patients-ages-12-17-300099548.html. Accessed June 30, 2015. See announcement here.
Device’s Neurostimulation Reduced Frontalis Muscle Contraction.
• Scientists in Italy studied the use of the Cefaly device, a cranial analgesic electrotherapeutic device, in 23 patients with chronic migraine. The patients underwent neurological examinations and EMG prior to using the Cefaly device and during the neurostimulation.
• EMG results showed a significant increase in amplitude and frequency values in the frontalis, anterior temporalis, auricularis posterior, and middle trapezius muscles.
• If validated further, the Cefaly device could be used for direct neuromuscular stimulation and to reduce frontalis muscle contraction.Source: Didier HA, et al. Electromyography data in chronic migraine patients by using neurostimulation with the Cefaly Â® device. Neurol Sci.2015;36 Suppl. 1:115-119. See abstract here.
Doppler Pinpoints Migraine Trigger Site.
• Scientists conducted a retrospective review of patients with migraine to see if Doppler could pinpoint the most intense pain site identified by the patient and whether this site was associated with an artery or involved nerve.
• Prior to undergoing surgical treatment for migraine headaches involving the auriculotemporal nerve, patients were asked to point to the most intense headache site by using their finger tip.
• In 100% of the patients studied, a positive Doppler signal over the site of pain was associated with intraoperative presence of the superficial temporal artery or its branches.
• The researchers removed the offending artery in all 34 sites noted in the study. Source: Guyuron B, et al. Use of a Doppler signal to confirm migraine headache trigger sites. Plast Reconstr Surg. 2015;135:1109-1112. See abstract here.
• Zolmitriptan can now be prescribed at a starting dose of 2.5 mg in pediatric patients aged 12 to 17 years.
• The Cefaly device, a cranial analgesic electrotherapeutic device, was able to cause neuromuscular facilitation and may help to reduce contraction of frontalis muscles in patients with chronic migraine.
• Doppler signal could successfully predict the presence of an artery at the most painful site of a migraine (as identified by a patient), which can lead to location of the nerve irritation and ultimately, the ability to successfully remove the offending artery during surgery.