What Is Trigeminal Nerve Stimulation?

Trigeminal nerve stimulation includes a type of non-invasive medical therapy using a small electrical device that’s placed on the forehead. It is approved for the prevention or relief of migraine headaches. The treatment is used at home and follows a specified schedule.

Other types of trigeminal nerve stimulation being investigated in research trials involve numerous methods, including acupuncture, injections, or electrical devices.

What Is the Trigeminal Nerve? 

The trigeminal nerves are a pair of the 12 pairs of cranial nerves. This nerve transmits sensory inputs from the face to the brain. It has three main branches, which is why it is called the trigeminal nerve. The branches are called V1, V2, and V3.

An injury of this nerve can cause a change in facial sensation. Pain is the most common consequence of injuries or inflammation of the trigeminal nerve.

Trigeminal neuralgia is a painful condition that causes severe pain in the face, usually on one side, corresponding to one or more trigeminal nerve branches. This condition is associated with injury, irritation, or inflammation affecting the trigeminal nerve.

Migraine and other headache types have also been associated with trigeminal nerve irritation, but the exact relationship is not well established. 

What Is Trigeminal Nerve Stimulation Used For? 

The idea behind trigeminal nerve stimulation is that modifying the action of this nerve can relieve certain conditions.

Cefaly is a device approved by the Food and Drug Administration (FDA) for adults 18 and older to treat and prevent migraine headaches. It works by stimulating the trigeminal nerve externally with electrical signals transmitted through the skin.

Relivion is a device used externally to stimulate the trigeminal and occipital nerves. It is available with limited access for acute migraine treatment. It is also being investigated in research trials to treat major depressive disorder.

There are also other types of trigeminal nerve treatments that are not directly considered stimulation, and these interventions are used for various conditions. 

Examples include: 

• External trigeminal nerve stimulation is being studied as a possible therapy for treating some types of epilepsy (a condition with electrical disturbances in the brain).
• Acupuncture is a treatment in which a needle-based therapy is applied near the trigeminal nerve. This has been used to treat certain forms of tinnitus (ringing in the ears).
• Injection of anti-inflammatory or pain medication near the trigeminal nerve is used to relieve symptoms caused by irritation or inflammation of the trigeminal nerve. 
• Surgery is sometimes recommended for the treatment of trigeminal neuralgia. Procedures include ligation (cutting) a section of the trigeminal nerve to reduce sensitivity or surgery to relieve trigeminal nerve compression. 

How Do You Use Trigeminal Nerve Stimulation? 

The devices approved for trigeminal nerve stimulation treatment are placed on the forehead for a specified amount of time.

It is important to discuss these treatments with your neurologist (specialist in treating conditions affecting the nervous system) or psychiatrist and to use them in the way your healthcare provider recommends. 

For acute migraine treatment, you would use the device during your migraine for the recommended amount of time. For migraine prevention, the Cefaly device is intended for daily use. 

How Does Trigeminal Nerve Stimulation Work? 

Research suggests trigeminal nerve stimulation sends electrical impulses to the trigeminal nerve to modify pain transmission to the brain. Experimental research also indicates this may affect metabolic activity in areas of the brain that process pain, and this could affect the experience of pain.

Is It Safe? 

Trigeminal nerve stimulation with approved devices and for approved uses is considered safe. However, the treatment can cause some side effects. While most study participants and people using the devices have not had to stop using the devices due to side effects, side effects did cause some study participants to stop using the treatment.

The most common side effects are sleepiness and paresthesia (unusual sensations).

As you begin to understand how this treatment affects your condition and as you learn your pattern of side effects, you can adjust your activities to ensure that you stay safe. 

Summary

Trigeminal nerve stimulation is a relatively new technique in which external stimulation with a device placed on the forehead is used to treat or prevent migraines. These devices are believed to modify pain transmission and processing through communication between the trigeminal nerve and the brain.

Currently, there are two devices for this use available in the United States—Cefaly and Relivion. Other types of treatment for conditions that involve the trigeminal nerve include acupuncture, injections, and surgery. 

A Word From Verywell 

If you have migraines, it can be helpful but overwhelming to keep up with all the different treatment options. Most people do experience improvement in the frequency and severity of migraines with acute and preventative treatments.

Some people have been pleased with the alternative of having non-medication-based treatment options such as trigeminal nerve stimulation. If you think this might be a good choice, talk with a healthcare provider about the pros and cons of this treatment choice.