Table of ContentsView AllTable of ContentsWhat Is TNS?How It WorksIndicationsUsing a TNS DeviceSafetyOther Treatments
Table of ContentsView All
View All
Table of Contents
What Is TNS?
How It Works
Indications
Using a TNS Device
Safety
Other Treatments
Trigeminalnerve stimulation (TNS) includes a type of non-invasive medical therapy using a small electrical device that’s placed on the forehead. It is approved for the treatment ofmigraineheadaches andattention deficit hyperactivity disorder(ADHD) in children. 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 other electrical devices.
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What Is Trigeminal Nerve Stimulation?
Trigeminal nerve stimulation (TNS) is a non-invasive medical treatment that uses mild electrical signals to stimulate branches of the trigeminal nerve.
What is the trigeminal nerve?Thetrigeminal nervesare a pair of the 12 pairs of cranial nerves. This nerve has three main branches and transmits sensory inputs from the face to the brain. 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.
What is the trigeminal nerve?
Thetrigeminal nervesare a pair of the 12 pairs of cranial nerves. This nerve has three main branches and transmits sensory inputs from the face to the brain. 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.
Thetrigeminal nervesare a pair of the 12 pairs of cranial nerves. This nerve has three main branches and transmits sensory inputs from the face to the brain. 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.
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.
According to a 2023 review published inBioelectronic Medicine, trigeminal nerve stimulation may be able to activate powerful mechanisms, including modulation of neuropeptides, neuronal signaling, and theautonomic nervous system(ANS).
What Conditions Can TNS Treat?
Trigeminal nerve stimulation has been used to treat a variety of health conditions such as migraine, ADHD in children, cognitive/balance dysfunction, major depressive disorder, and more.
Approved Devices
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 treatmajor depressive disorder.
The Monarch external Trigeminal Nerve Stimulation (eTNS) System is FDA-approved to treat ADHD in patients ages 7 to12 years old who are not currently taking prescription ADHD medication. Studies have shown that eTNS can increase activity in areas of the brain that are important in regulating attention, emotion, and behavior.
Do I need a prescription to use trigeminal nerve stimulation?You do not need a prescription to obtain a Cefaly device; however, you need a prescription to get a Relivion or Monarch device.
Do I need a prescription to use trigeminal nerve stimulation?
You do not need a prescription to obtain a Cefaly device; however, you need a prescription to get a Relivion or Monarch device.
How Do You Use TNS Devices?
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 yourneurologist(a specialist in treating conditions affecting the nervous system) or psychiatrist and to use them in theway 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.
To treat pediatric ADHD, it’s recommended that the Monarch device be worn nightly (while sleeping) for at least eight hours.
How much does trigeminal nerve stimulation cost?The cost of trigeminal nerve stimulation treatment can vary depending on the type of device used and whether or not your insurance provider covers it. The Cefaly device costs about $400, whereas the Monarch eTNS system costs around $1,000.
How much does trigeminal nerve stimulation cost?
The cost of trigeminal nerve stimulation treatment can vary depending on the type of device used and whether or not your insurance provider covers it. The Cefaly device costs about $400, whereas the Monarch eTNS system costs around $1,000.
Is Trigeminal Nerve Stimulation Safe?
Trigeminal nerve stimulationwith 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).
PrecautionsBecause of the potential for sleepiness, you must be careful about activities such as driving, using potentially dangerous equipment, and swimming when using trigeminal nerve stimulation. Talk with a healthcare provider about whether this is a good option for your situation.
Precautions
Because of the potential for sleepiness, you must be careful about activities such as driving, using potentially dangerous equipment, and swimming when using trigeminal nerve stimulation. Talk with a healthcare provider about whether this is a good option for your situation.
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.
Other Trigeminal Nerve Treatments
There are other trigeminal nerve treatments available that are not directly considered stimulation. Nonetheless, these interventions may be used to treat various conditions.
Examples include:
Do vagus nerve stimulators actually work?Vagus nerve stimulation(VNS) is another neurostimulation technique that uses electrical impulses to stimulate the leftvagus nerve. It is FDA-approved to treat depression and some forms of epilepsy.
Do vagus nerve stimulators actually work?
Vagus nerve stimulation(VNS) is another neurostimulation technique that uses electrical impulses to stimulate the leftvagus nerve. It is FDA-approved to treat depression and some forms of epilepsy.
Summary
Trigeminal nerve stimulation is a relatively new technique in which external stimulation with a device placed on the forehead is used to treat certain conditions, such as migraine or pediatric ADHD. These devices are believed to modify pain transmission and processing through communication between the trigeminal nerve and the brain.
Devices available in the United States include Cefaly, Relivion, and Monarch. If you think a TNS device may be a good choice, talk with a healthcare provider about the pros and cons of this treatment choice. Other types of treatment for conditions that involve the trigeminal nerve include acupuncture, injections, and surgery.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Powell K, Lin K, Tambo W, et al.Trigeminal nerve stimulation: a current state-of-the-art review.Bioelectron Med. 2023;9(1):30. doi:10.1186/s42234-023-00128-zUrculo E, Elua A, Arrazola M, Torres P, Torres S, Undabeitia J.Trigeminal root massage in microsurgical treatment of trigeminal neuralgia patients without arterial compression: when, how and why.Neurocirugia(Astur: Engl Ed). 2020;31(2):53-63. doi:10.1016/j.neucir.2019.07.003Daniel O, Sharon R, Tepper SJ.A device review of Relivion®: an external combined occipital and trigeminal neurostimulation (eCOT-NS) system for self-administered treatment of migraine and major depressive disorder.Expert Rev Med Devices. 2021;18(4):333-342. doi:10.1080/17434440.2021.1908122Chou DE, Shnayderman Yugrakh M, Winegarner D, Rowe V, Kuruvilla D, Schoenen J.Acute migraine therapy with external trigeminal neurostimulation (ACME): a randomized controlled trial.Cephalalgia.2019;39(1):3-14. doi:10.1177/0333102418811573Yuan H, Chuang TY.Update of neuromodulation in chronic migraine.Curr Pain Headache Rep. 2021;25(11):71. doi:10.1007/s11916-021-00988-7Daniel O, Sharon R, Tepper SJ.A device review of Relivion®: an external combined occipital and trigeminal neurostimulation (eCOT-NS) system for self-administered treatment of migraine and major depressive disorder.Expert Rev Med Devices. 2021;18(4):333-342. doi:10.1080/17434440.2021.1908122Food and Drug Administration.FDA permits marketing of first medical device for treatmentof ADHD.Children and Adults with Attention-Deficit/Hyperactivity Disorder.Parents cautious of new FDA-approved device for kids with ADHD.Cefaly.Cefaly device.Law HK, Corradino MD.Neuropuncture, an effective treatment method for patients with subjective tinnitus accompanied with hearing loss: case reports.Med Acupunct.2021;33(4):295-301. doi:10.1089/acu.2020.1514Johnson RL, Wilson CG.A review of vagus nerve stimulation as a therapeutic intervention.J Inflamm Res.2018;11:203-213. doi:10.2147/JIR.S163248
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Powell K, Lin K, Tambo W, et al.Trigeminal nerve stimulation: a current state-of-the-art review.Bioelectron Med. 2023;9(1):30. doi:10.1186/s42234-023-00128-zUrculo E, Elua A, Arrazola M, Torres P, Torres S, Undabeitia J.Trigeminal root massage in microsurgical treatment of trigeminal neuralgia patients without arterial compression: when, how and why.Neurocirugia(Astur: Engl Ed). 2020;31(2):53-63. doi:10.1016/j.neucir.2019.07.003Daniel O, Sharon R, Tepper SJ.A device review of Relivion®: an external combined occipital and trigeminal neurostimulation (eCOT-NS) system for self-administered treatment of migraine and major depressive disorder.Expert Rev Med Devices. 2021;18(4):333-342. doi:10.1080/17434440.2021.1908122Chou DE, Shnayderman Yugrakh M, Winegarner D, Rowe V, Kuruvilla D, Schoenen J.Acute migraine therapy with external trigeminal neurostimulation (ACME): a randomized controlled trial.Cephalalgia.2019;39(1):3-14. doi:10.1177/0333102418811573Yuan H, Chuang TY.Update of neuromodulation in chronic migraine.Curr Pain Headache Rep. 2021;25(11):71. doi:10.1007/s11916-021-00988-7Daniel O, Sharon R, Tepper SJ.A device review of Relivion®: an external combined occipital and trigeminal neurostimulation (eCOT-NS) system for self-administered treatment of migraine and major depressive disorder.Expert Rev Med Devices. 2021;18(4):333-342. doi:10.1080/17434440.2021.1908122Food and Drug Administration.FDA permits marketing of first medical device for treatmentof ADHD.Children and Adults with Attention-Deficit/Hyperactivity Disorder.Parents cautious of new FDA-approved device for kids with ADHD.Cefaly.Cefaly device.Law HK, Corradino MD.Neuropuncture, an effective treatment method for patients with subjective tinnitus accompanied with hearing loss: case reports.Med Acupunct.2021;33(4):295-301. doi:10.1089/acu.2020.1514Johnson RL, Wilson CG.A review of vagus nerve stimulation as a therapeutic intervention.J Inflamm Res.2018;11:203-213. doi:10.2147/JIR.S163248
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Powell K, Lin K, Tambo W, et al.Trigeminal nerve stimulation: a current state-of-the-art review.Bioelectron Med. 2023;9(1):30. doi:10.1186/s42234-023-00128-zUrculo E, Elua A, Arrazola M, Torres P, Torres S, Undabeitia J.Trigeminal root massage in microsurgical treatment of trigeminal neuralgia patients without arterial compression: when, how and why.Neurocirugia(Astur: Engl Ed). 2020;31(2):53-63. doi:10.1016/j.neucir.2019.07.003Daniel O, Sharon R, Tepper SJ.A device review of Relivion®: an external combined occipital and trigeminal neurostimulation (eCOT-NS) system for self-administered treatment of migraine and major depressive disorder.Expert Rev Med Devices. 2021;18(4):333-342. doi:10.1080/17434440.2021.1908122Chou DE, Shnayderman Yugrakh M, Winegarner D, Rowe V, Kuruvilla D, Schoenen J.Acute migraine therapy with external trigeminal neurostimulation (ACME): a randomized controlled trial.Cephalalgia.2019;39(1):3-14. doi:10.1177/0333102418811573Yuan H, Chuang TY.Update of neuromodulation in chronic migraine.Curr Pain Headache Rep. 2021;25(11):71. doi:10.1007/s11916-021-00988-7Daniel O, Sharon R, Tepper SJ.A device review of Relivion®: an external combined occipital and trigeminal neurostimulation (eCOT-NS) system for self-administered treatment of migraine and major depressive disorder.Expert Rev Med Devices. 2021;18(4):333-342. doi:10.1080/17434440.2021.1908122Food and Drug Administration.FDA permits marketing of first medical device for treatmentof ADHD.Children and Adults with Attention-Deficit/Hyperactivity Disorder.Parents cautious of new FDA-approved device for kids with ADHD.Cefaly.Cefaly device.Law HK, Corradino MD.Neuropuncture, an effective treatment method for patients with subjective tinnitus accompanied with hearing loss: case reports.Med Acupunct.2021;33(4):295-301. doi:10.1089/acu.2020.1514Johnson RL, Wilson CG.A review of vagus nerve stimulation as a therapeutic intervention.J Inflamm Res.2018;11:203-213. doi:10.2147/JIR.S163248
Powell K, Lin K, Tambo W, et al.Trigeminal nerve stimulation: a current state-of-the-art review.Bioelectron Med. 2023;9(1):30. doi:10.1186/s42234-023-00128-z
Urculo E, Elua A, Arrazola M, Torres P, Torres S, Undabeitia J.Trigeminal root massage in microsurgical treatment of trigeminal neuralgia patients without arterial compression: when, how and why.Neurocirugia(Astur: Engl Ed). 2020;31(2):53-63. doi:10.1016/j.neucir.2019.07.003
Daniel O, Sharon R, Tepper SJ.A device review of Relivion®: an external combined occipital and trigeminal neurostimulation (eCOT-NS) system for self-administered treatment of migraine and major depressive disorder.Expert Rev Med Devices. 2021;18(4):333-342. doi:10.1080/17434440.2021.1908122
Chou DE, Shnayderman Yugrakh M, Winegarner D, Rowe V, Kuruvilla D, Schoenen J.Acute migraine therapy with external trigeminal neurostimulation (ACME): a randomized controlled trial.Cephalalgia.2019;39(1):3-14. doi:10.1177/0333102418811573
Yuan H, Chuang TY.Update of neuromodulation in chronic migraine.Curr Pain Headache Rep. 2021;25(11):71. doi:10.1007/s11916-021-00988-7
Food and Drug Administration.FDA permits marketing of first medical device for treatmentof ADHD.
Children and Adults with Attention-Deficit/Hyperactivity Disorder.Parents cautious of new FDA-approved device for kids with ADHD.
Cefaly.Cefaly device.
Law HK, Corradino MD.Neuropuncture, an effective treatment method for patients with subjective tinnitus accompanied with hearing loss: case reports.Med Acupunct.2021;33(4):295-301. doi:10.1089/acu.2020.1514
Johnson RL, Wilson CG.A review of vagus nerve stimulation as a therapeutic intervention.J Inflamm Res.2018;11:203-213. doi:10.2147/JIR.S163248
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