1.1 Current evidence on transcutaneous electrical stimulation of the supraorbital nerve for treating and preventing migraine raises no major safety concerns. The evidence on efficacy is limited in quantity and quality. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.
1.2 Clinicians wishing to offer transcutaneous electrical stimulation of the supraorbital nerve for treating and preventing migraine should:
Inform the clinical governance leads in their NHS trusts.
Ensure that patients understand the uncertainty about the procedure's efficacy and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.
1.3 Patient selection should normally be done by clinicians in specialist headache clinics.
1.4 NICE encourages further research on transcutaneous electrical stimulation of the supraorbital nerve for treating and preventing migraine. Data should be collected for all patients not entered into controlled trials. Studies should describe clearly whether the procedure is used for treatment or prevention. They should include details of patient selection and the dose and frequency of use. Outcome measures should include the number and severity of migraine episodes, quality of life in the short and long term and any changes in medication. The development of any complications after starting treatment should be documented. NICE may update the guidance on publication of further evidence.