testing. Histamine dihydrochloride is a product planned
to be used by SC injection. Histamine is a chemical
found in some of the body's cells that causes many of the
symptoms of allergies, such as a runny nose or sneezing. It
is believed to be involved in the pathogenesis of migraine
and cluster headaches. Also, in early testing, is the mineral
supplement, magnesium L-lactate dehydrate (MLD10)
taken daily. Magnesium has been used for several years for
migraine prevention.
In addition to pharmacological agents, various medical
devices are also currently being investigated and evaluated.
The vagal nerve is the tenth cranial nerve, supplying the
heart, lungs, upper digestive tract, and other organs of the
chest and abdomen. A hand-held vagal nerve stimulator as
well as transcranial magnetic stimulation are non-invasive
options in the pipeline that are currently being used or
migraine prevention as well as for acute therapy. Occipital
(back of the head) nerve, supraorbital nerve (above the
orbit of the eye), and temporo-auricular (pertaining to
the temple and the ear) nerve stimulation are also being
used but require surgical implantation. These devices are
considered, at this time, to be investigational. Similarly, a
sphenopalatine ganglion (SPG) (relating to the sphenoid
bone at the lower part of the skull and the palate)
implantable stimulator is currently being investigated for
chronic cluster headache. Could this intervention also,
in the future, be considered for prevention of intractable
chronic migraine? In addition, an intranasal kinetic
oscillation stimulation device is being evaluated for
migraine treatment.
Conclusions
In summary, we have found in the last few years that
investigational drugs and devices are being increasingly
evaluated for migraine prevention. In my own practice,
we are currently involved in the clinical trials of several
of these pharmaceutical products and devices. As none
of the commercially available agents are effective and
tolerable for all migraine patients who need them, any new
additions that become commercially available are a