Transcutaneous stimulation of the cervical branch of the vagus nerve for cluster headache and migraine

The condition

Cluster headaches are attacks of severe pain on one side of the head, usually around the eye. Other symptoms include a red and watery eye and a runny nose. Cluster headaches can happen many times a day and last from a few minutes to several hours, over a period of days, months or years.

Migraines are severe headaches, often associated with feeling sick and sensitivity to light and sound. Some patients have some form of warning (an 'aura'), which can include visual disturbances, confusion or difficulty speaking, usually before the headache starts. Migraines can last for several hours or days, or longer.

The usual treatment for cluster headache attacks is oxygen or drugs such as triptans. Drugs such as corticosteroids or verapamil may stop or reduce the frequency of attacks.

For migraine attacks the usual treatment is drugs including triptans, painkillers and anti-sickness drugs. Types of drug that can help stop or reduce the frequency of attacks are beta‑blockers, tricyclic antidepressants and some drugs used for treating epilepsy.

Other procedures, including different types of nerve stimulation, are sometimes tried if the person's cluster headaches or migraine do not respond to drug treatment.

NICE has looked at using transcutaneous stimulation of the cervical branch of the vagus nerve as another treatment option.

NHS Choices and NICE's information for the public about headaches in over 12s may be a good place to find out more.