Transcranial Magnetic Stimulation (TMS)
Transcranial Magnetic Stimulation (TMS)
What is TMS?
Transcranial Magnetic Stimulation involves the use of magnetic pulses delivered to the brain via a device which does not touch the skin or scalp. The magnetic pulses cause tiny electrical currents in the brain tissue which modify and excite neurons. According to eNeura “This process is thought to interrupt the abnormal electrical activity associated with migraine and cortical spreading depression (CSD)”.
‘eNeura‘ is one of the companies that supplies a TMS device. It is currently available in the US and UK. Their ‘Spring TMS’ device is small, portable and delivers a mild and brief pulse of magnetic energy to the back of the head. If the first pulse fails, it can be used again, with only a short interval between pulses (for the device to recharge). It is quick and easy to use. It is only available on prescription, and currently only from the UK or US. For more on how it works and how to go about getting a prescription, go to the eNeura website They have a video with instructions on its use. For information on how to get one of these devices, see the following PDF
MAI recently spoke to a representative from eNeura and are hopeful that this device will soon be available in Ireland. At the moment, Irish patients can be prescribed its use but only if they are referred to places such as King’s College London where Professor Peter Goadsby and his colleagues currently prescribe the device.
When the doctor sends your prescription (on a form filled out by both you and them) they send it to eNeura who send you the device along with an SD card or SIM card which has your individual programme on it. When you get the device you insert the card into the device and turn it on. There is a nurse advice line available for training and help (which you must go through), then you can get zapping!
Are there Side-effects?
Like all migraine treatments, there is an element of risk from side-effects with TMS. Generally TMS is well tolerated and little or no side-effects are reported. However, at the moment there is no data about the long-term effects of TMS. Immediate side effects may include minor vertigo or dizziness, nausea, slight pain at the sight of the pulse, tingling.
There are a lot of factors to consider when thinking about using a TMS device. eNeura have a list of warnings, precautions and contraindications that come with their ‘Spring TMS device. These are not to put people off just to make them fully aware of and comply with the safe use of the system.
Warnings about when not to use the device include but are not limited to;
- Near flammable gases or petrol
- When it’s wet, or near water
- During the Aura phase of your attack, use when the pain hits
- It doesn’t work on Cluster Headache
Precautions to keep the device at least 2 feet away from certain objects when it’s on include but are not limited to;
- Mobile phones
- Wireless network routers
- Cordless telephones and their bases
- Credit Cards
- Flash memory sticks
- MP3 players
- Digital cameras
Contraindications include but are not limited to having any or all of the following implants;
- Implanted Vagus Stimulator
- Aneurysm clips or coils
- Cochlear Implants
- Any implanted medical device with metals of conductive materials
You can continue to use your normal migraine medications while using the TMS device but you should regularly consult with your doctor.
How much does it cost and how do I get it?
The TMS device is prescription only and cannot be bought, but can be rented from eNeura in the UK for;
- 3 months @ £499 Sterling
- 6 months @ £900 Sterling
- 1 Year @ £1,611.60 Sterling
After you and your doctor fill out the necessary forms, you need to fill out a rental agreement form. You send it all off and as I mentioned above, eNeura will send you the device along with an SD card or SIM card which has your personal treatment plan on it.
You must always discuss it with your doctor when embarking on a new treatment plan.