When do you recommend electrical stimulation (Cefaly device) in patients with chronic migraine, if at all?

The Cefaly device provides transcutaneous electrical nerve stimulation to the supraorbital nerves and has regulatory approval both as an acute and preventive treatment. This device and other neuromodulatory therapies are useful in several settings for the treatment of chronic migraine:

1. Some people with CM prefer to avoid medications and as an acute or preventive treatment neuromodulation along with behavioral approaches, addressing medication overuse and nutraceuticals can provide important options. Most people with CM need more than a single device and I prefer to use neuromodulation as an adjunct.
2. Many people have incomplete responses to their pharmaceutical preventive therapies. In this context, 20 minutes per day of treatment with Cef...