Thursday, July 21, 2016

That Star Wars Looking Device: A Review of Cefaly For Migraine


Cefaly is a TENS unit head piece that attaches to the forehead via an adhesive electrode, and is becoming a first line treatment for many migraine and headache sufferers.  Cefaly sends electrical impulses through the brain and is specifically designed for migraine/headache sufferers as an alternative or compliment to medication. Cefaly was available in European countries for years before it was finally approved by the FDA in March of 2014. Back in 2014, it was very difficult to find solid information and reviews on Cefaly because there was only a small population using it. However, it quickly gained popularity here in the states and now there are a host of reviews from users and medical journals online.

Modern medication used to treat migraines generally comes with too many undesirable side effects, making migraines even more difficult to treat. Cefaly is an alternative to these medications because the makers boast of very few side effects which are all reversible. According to the Cefaly website, side effects could include: intolerance to the sensation on the forehead (1.25%), feelings of fatigue during and after the session (.64%), headache after one session (.52%), and irritation of the skin on the forehead (.42%).


 Most headaches and migraines involve the trigeminal nerve, a cranial nerve located in the center of the brain, with nerves extending to the forehead, the facial region, reaching to the sides above the ears, as well as behind the eyes.  Cefaly targets the trigeminal nerve with neurostimulation, producing a "relaxing effect" to these nerves and therefore decreasing migraines. The makers of Cefaly claim regular use of the device will eventually reduce the number of migraine and headache attacks, mainly due to precise stimulation of the trigeminal nerve. In order to get the full benefits, patients need to use the device at least once a day, for a full session each lasting 20 minutes.  I heard the CEO of Cefaly, Pier Rigaux, speak at the Migraine World Summit this year and he recommended using it twice a day in order for it to be most effective.

Those who would most benefit from Cefaly have one or more of the following conditions:

Common migraine

Migraine with aura

Ophthalmic migraine

Episodic migraine

Chronic migraine

Menstrual migraine

Anterior tension type headache

Posterior tension type headache

Chronic headache

Occipital neuralgia


I first heard about Cefaly from my friend Eric in 2014 when he posted an article on his Facebook page for his wife who had recently been struggling with migraines, and was then later diagnosed with fibromyalgia.  As a chronic migraine sufferer at the time, I was absolutely fascinated by the possibility of a TENS type unit that could be used for migraine, in place of medication.  I immediately began doing my research and trying to figure out if it was right for me. The Cefaly website claimed an astounding 71% patient satisfaction rate and a 75% reduction in headache medicine use. Because there is a 60 day money back guarantee, they base their satisfaction rate on the amount of patients that do not return the device. In 2014 I could only find a few reviews of people actually using Cefaly, and very little in medical journals, but today you can find a plethora of information online. You can also find testimonials of people using Cefaly on their website here, and studies since 2014 are showing around a 50-60% satisfaction rate among patients who use the device regularly for 60 days.

In 2014, I convinced my doctor to write me a prescription for Cefaly and I was so excited to try it. The Cefaly comes with 3 electrodes that last anywhere from 15-30 uses.  Before placing the electrode on the forehead slightly above the eyebrows, it is important to wash the forehead with rubbing alcohol. This makes the electrodes last longer. The device itself rests on the electrode and once you push the start button, immediately you can sense the electrical impulses on the top of your head. The intensity rises and peaks in intensity at 12 minutes. It took me a long time to be able to build up to full strength as it was a bit painful in the beginning, although nothing compared to the pain of a migraine or headache. Even though the Cefaly instruction manual says you can move about as normal, I found I was only comfortable when lying down. This lasted for about two months, but I am now able to fold laundry and pick up toys while doing a session at full intensity.  I can honestly say I am not sure it has done a lot for me in the treatment of migraines and headaches, as I saw very little change after using the device for three months. I am a firm believer that migraine treatment is a 360 approach and there is not a one cure-all, but instead the implementation of diet and lifestyle changes, holistic approaches, as well as medical intervention may all be necessary. Even though I don’t believe Cefaly worked for me, I still use the Cefaly regularly.  If nothing else, it does feel really good during a headache or migraine attack, and occasionally I notice a reduction in pain after use.


Just this week, Cefaly announced the release of what they are calling the Cefaly II, exclusively to the United States.  It works the same as the first Cefaly, except it is a smaller device and sits on the forehead magnetically, instead of the larger band. Because Cefaly II is so much smaller, it is easier to travel with and even “wear” out in public. (You won’t see me out in public wearing
either device.) It also comes with a power cord and adapter for recharging the battery, whereas Cefaly I requires 2 AAA batteries. The cost is still the same. For $349 USD, you get the Cefaly and 3 electrodes, plus shipping and handling, for a total cost of $364 USD. Keep in mind, the Cefaly requires a prescription and most insurances do not cover it. There have been reported cases in which insurance companies paid a partial amount, but you need to contact your own company to find out. There is also the added cost of replacing electrodes approximately every three months or less which costs $25 for three. Given Cefaly is having around a 50% success rate, I think it is definitely worth giving it a try if you can afford it. Worst case scenario, it doesn’t work and you simply return it in 60 days for your money back.

I recently learned on the Cefaly website about the exciting possibilities for the use of Cefaly in Fibromyalgia. Cases of Fibromyalgia in America, particularly in women, are on the rise and like chronic migraine is extremely difficult to treat. The University of Cincinnati announced earlier this year, they were beginning clinical trials to see if Cefaly was also effective for the chronic pain associated with fibromyalgia. According to Leslie Arnold, professor and physician at the University of Cincinnati, “…Fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals,” and since Cefaly targets the pain center of the brain, there could be a great opportunity for treating fibromyalgia. The clinical trial is open to adults ages 18-65 who have a diagnosis of fibromyalgia. Everyone who enrolls will receive a Cefaly at no cost and if patients show improvement, they will go on to controlled studies. You can find more information about this at Fibromyalgia News Today.

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