Cefaly, the Anti-Migraine Device

This thing might work for some. Proof of its working is thin, but that tends to be a chronic problem with this kind of device. The patients studied with Cefaly had migraines not over a few times a month. My patients — who use marijuana, generally of the sativa type — have the most intense migraine headaches I have ever seen or heard of and have them on a daily basis. This is pretty amazing, since I worked for one year in a major Midweste
university headache clinic. The major questions are what causes migraine headaches, and whether this device indeed nips them in the bud.
The technology seems identical to the TENS (Transcutaneous Electric Nerve Stimulator), which was based on the Melzack and Wall “gate control theory” of pain — long discredited as an oversimplification. I mean, the idea is that a nerve is supposed to be “confused” when it is hit with a “tingly” stimulation and this is supposed to block the painful message being carried along that same nerve. The gate control theory was introduced in 1965 and was already considered obsolete by many when I started studying this sort of thing. Mainly, this was because there seem to be different kind of fibers that carry these messages. But what the heck; it is harmless and it works, so people often still try to use TENS. I am very happy it works for some folks.
Also, there are lots of descriptors about the bifurcation of the trigeminal nerve. Trigeminal neuralgia remains generally considered to be a separate affliction. I remember with joy when we ordered one from Australia for my Mother-in-Law-Carolyn-of-Blessed-Memory. Her sciatica had been bothering her, and I put one on her when she was really hurting. Then I taught her some steps of an Irish jig, which she demonstrated when her husband and mine came back from a brief outing. Carolyn loved that apparatus; even loved the tingly feeling when it was turned up a bit high. When I tried to use one for a neuropathy of the lower limbs, it did not do much.
As usual, the insurers seem to be limiting the use of this technology, with a high denial rate of over 42 percent.
What causes migraine? People are still arguing, but the most solid arguments seem to be about the tiny nerves around blood vessels at various places, or depths, in the brain.
Cefaly is already approved in Canada, without a single article I can find in the National Library of Medicine that mentions it specifically. The author here is correct that ISO is an organization of standardization. CE seems to have something to do with marketing standardization; there is even a special quick and easy guide to get one. I am convinced of the safety of Cefaly. The efficacy is possible, but not proven, and I cannot get numbers. Cost is about three hundred dollars according to a couple of Canadian sources, including the Skeptic North article linked above. The migraine patient who decides it is worth a try needs to know these things.