Kinetic oscillation stimulation for the preventive treatment of refractory chronic migraine: a case series

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Background: Refractory migraine refers to a subtype of chronic migraine in which individuals experience severe and disabling attacks that do not respond adequately to any pharmacological treatment. In recent years, neuromodulation techniques have emerged as promising therapeutic avenues for refractory migraine management. Methods: Four patients with refractory chronic migraine were offered a six-week cycle of kinetic oscillation stimulation (KOS), a novel approach of neuromodulation whose target is the sphenopalatine ganglion (SPG). Migraine frequency and medication usage were recorded in a diary; intensity of pain and impact of migraine on patient’s behavior were assessed with validated clinical scales. Results: All except one patient completed the scheduled sessions. Severity of pain and drug consumption remained stable in most cases. After one month of active stimulation, migraine frequency did not differ substantially from pre-operative monthly average, except in one subject who recorded a reduction of 11 monthly migraine days (MMD). A second treatment cycle was proposed for this patient, considering the excellent clinical outcome. Conclusions: KOS could be a helpful resource and drug-sparing option for selected patients with refractory migraine. However, more evidence is needed to confirm its efficacy and establish a shared usage protocol.

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