While CEFALY may be the #1 prescription-free neuromodulation device for migraine, there are other options that are available with a prescription. One of these is vagus nerve stimulation, or VNS.
Overview of eTNS for migraine vs. VNS for migraine
eTNS and VNS are different forms of non-invasive neurostimulation for migraine. Simply put, neurostimulation is a medical treatment that uses mild, precise electrical impulses to change the behavior of nerves.
VNS acts on the vagus nerve. This nerve runs from the lower part of the brain through the neck to the chest and stomach. You have two vagus nerves, one on each side of the body. Vagus nerve stimulation sends impulses to the brain. Surgically implanted VNS devices have been shown to help relieve epilepsy, depression, and other conditions. External VNS is used to prevent and treat migraine as well as cluster headache
External trigeminal neurostimulation (eTNS) directly targets the trigeminal nerve, which is the largest cranial nerve and the primary pathway for migraine pain. Gentle electrical impulses both stimulate and desensitize the nerve, interrupting pain signals and reducing migraine frequency.
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CEFALY vs. VNS for migraine: How treatment works
To use a VNS device for migraine, you apply a conductive gel and hold the device against your neck. Correct placement is key, as it can be tricky to find the right spot to stimulate the vagus nerve. Users usually feel a tingling and a downward pulling on their lip (this is a muscle contraction triggered by VNS).
For preventing migraine, users should do 2 two-minute stimulations on the same side of the neck, twice daily (morning and night). For pain relief, do an additional set of 2 two-minute stimulations on the same side of the neck as needed. You can repeat the treatment if your pain persists, but you’re limited to 24 total per day.
To use CEFALY, lie down or recline and attach the device to the adhesive electrode on your clean, dry forehead. Start the 60-minute ACUTE treatment at the first sign of a migraine attack to relieve pain and other symptoms. Add the 20-minute PREVENT program to your bedtime routine to reduce migraine frequency.
CEFALY Connected works with the optional CeCe Migraine Management app to let you see your treatment in progress, track your stimulation intensity, and log treatments and migraine attacks. The leading VNS device for migraine doesn’t have an app.
| CEFALY | VNS migraine device | |
| Placement | Worn on forehead | Held against neck |
| Frequency | Use as needed for migraine painUse daily for migraine prevention | Use as needed for migraine painUse twice per day for migraine prevention |
| Session length | 60 minutes for ACUTE20 minutes for PREVENT | 2 x two-minute stimulations, repeated as needed, for pain relief2 x two-minute stimulations for prevention |
| Limited treatments? | No limitations; use as often as needed | Limited to 24 total per day |
| App | App available | App not available |
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CEFALY vs. VNS for migraine: Cost and accessibility
Users’ biggest concern about vagus nerve stimulation for migraine is the cost. Once you get a prescription, you must keep purchasing refill cards for the device at a cost of about $200 per month. Insurance coverage is limited; you may be able to get copay assistance or financial assistance.
CEFALY is available over the counter, without a prescription. Once you purchase CEFALY, it’s yours to keep — no refill costs or fees required. The only ongoing expense is replacement electrodes. The CEFALY Enhanced device costs $389, while the Bluetooth-enabled CEFALY Connected is $424 before discount or promotions are applied. Here are some ways to save on CEFALY!
CEFALY vs. VNS for migraine: Which is right for you?
One of the best things about neuromodulation is that it’s a low-risk migraine treatment. Both eTNS and VNS devices have been clinically proven to be safe, with no serious adverse side effects, and are FDA-cleared. And both can be used alongside other migraine treatments, such as medication.
Many people prefer CEFALY because it’s affordable and accessible. Unlike other devices, you don’t need a prescription and you don’t need to keep paying to refill it. Plus, you can return CEFALY within 90 days and get your money back if you don’t experience meaningful migraine relief and prevention. Find out why so many people call CEFALY a game-changing migraine treatment.
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