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If you have ever had a migraine headache, you know just how painful, debilitating, and even dangerous they can be. A new pacemaker for the brain, however, is helping some people make migraines a thing of their past.

Most people who have migraines take medications to try to prevent or relieve migraine attacks. The problem with medications is that they cause significant side effects.

  • Anti-seizure drugs, such as valproate sodium (Depacon, Depakote, Depakeen) and topiramate (Topamax) may reduce the severity and frequency of migraine attacks but they also cause weight gain, mood swings, and liver damage.
  • Beta-blockers, used to prevent migraines and also used to control high blood pressure, racing heart (tachycardia), and muscle tremors (many professional pool players take beta-blockers), can cause asthma and depression.
  • ACE-inhibitors, likewise used to prevent migraines and to control high blood pressure, such as the antihypertensive drug lisinopril (Zestril), sometimes trigger persistent dry cough that just won't go away.
  • Calcium channel blockers, used to fight high blood pressure and also to keep blood vessels from becoming too narrow or too wide, reduce the severity of migraines but increase risk of heart attack. They also cause severe constipation in most users.
  • Aspirin taken on a regular basis may stop the frequency and severity of migraine attacks, but it also can cause stomach upset and hearing loss.
  • Some of the older antidepressants, such as amytriptyline (Elavil), which costs just $4 a month even without a subsidy, help prevent migraine attacks, but they can cause severe high blood pressure when taken at the same time certain foods are eaten.
  • "Rescue medications" such as almotriptan (Axert), eletriptan (Relpax), Frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig) relieve pain but can actually aggravate nausea and vomiting. People who have had or who are at risk for heart attacks and strokes can't take them.
  • Herbal medications for preventing migraines, such as butterbur (also known as Petasites) and feverfew, are genuinely effective, but they present some of the same side effects as Aspirin.

So if you can't find a drug that works well, and many people who have migraines can't, you might prefer to see a doctor about getting a migraine zapper.

However, that technology isn't perfect, either.

  • The leads from the pacemaker to the base of the skull can move around. Additional surgery may be necessary to put them back in place. This happens in up to 42% of cases for some kinds of pacemaker surgery for migraine.
  • The surgery can cause infection, especially when the pacemaker is inserted in an alternative location, such as the buttocks. This happens up to 14% of the time.
  • And the zapper doesn't completely eliminate migraines. Only about 1/3 of patients report "greater than 50% reduction" in their pain. However, about 90% of migraine sufferers receiving the device report "significant" reduction in pain.

Occipital nerve stimulation isn't a miracle for migraines, but if nothing else works for you, you may want to try it. Surgeons all over the United States offer the procedure, and it is generally covered by health insurance.

  • Palmisani S, Al-Kaisy A, Arcioni R, Smith T, Negro A, Lambru G, Bandikatla V, Carson E, Martelletti P. A six year retrospective review of occipital nerve stimulation practice - controversies and challenges of an emerging technique for treating refractory headache syndromes. J Headache Pain. 2013 Aug 6.14(1):67. doi: 10.1186/1129-2377-14-67.
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