الفهرس 
IntroductionOnly 14 pages are availabe for public view
Abstract
Chronic migraine (CM) is a complex, progressive headache disorder affecting approximately 0.9-2.2% of the general adult population (Burstein et al., 2015).
CM is associated with significant disability, reduced health-related quality of life (HRQoL), and considerable healthcare cost (Dodick et al., 2010).
Few preventative treatments for CM have been investigated. The effectiveness of both acute migraine treatments and prophylactic medications may be further complicated by frequent overuse of acute headache pain medication (eg, simple analgesics, triptans, opioids, ergots) by this patient population.So alternative therapies are therefore warranted (Dodick et al., 2010).
One of these alternatives is transcutaneous electrical nerve stimulation (TENS) as a neurostimulation tool with the ability to send afferent input to CNS to activate descending pain inhibitory systems to reduce hyperalgesia. TENS showed positive results when used in migraine treatment but more studies still need to be conducted to evaluate efficacy and mode of action of TENS in migraine treatment(Vance et al., 2014).
Our double blinded sham controlled study examined the efficacy of 6 sessions of active TENS therapy applied to tender points related to supraorbital and/or greater occipital nerve versus sham stimulation in improving headache frequency, headache severity, headache index, abortive pills ,functional disability (HIT6 score).
The study included 35 chronic migraine patients who were recruited from headache and general neurology clinics in Ain-Shams University hospitals. Patients were asked to keep a baseline migraine dairy one month before being randomized to either group. Seven patients have been dropped out with the final number 13 patints in active group and 15 patients in sham one. Patients were assessed at 2 time points (baseline and 1 month after sessions) by migraine dairy ,disability scale (Hit-6).
The study results showed that active TENS achieved ≥ 50% decrease in total headache days frequency in 15.38 % of patients, migraine days frequency in 23.08% of patients and attack duration in 7.69 % of patients in active group as compared to sham (0.00%, 6.67%, and 0.00% respectively) which was non statistically significant.
Regards other outcomes, the headache severity (53.85% vs 13.33%), abortive pills intake (30.77% vs. 0.00%), functional disability ( ≥ 5 point reduction in HIT6 score) (69.23% vs 0.00%) were significantly improved in the active group compared to sham one.