Extended regular use of kinetic oscillation stimulation (KOS) in refractory chronic migraine: case report of a first, single-subject experience

Kinetic Oscillation Stimulation (KOS) is a novel and non-invasive neuromodulation method for migraine therapy. Emerging evidence suggests that applying low-frequency intranasal vibrations to the sphenopalatine ganglion (SPG) could be a safe and effective option for migraine treatment. We present a case of a 60-year-old man affected by refractory chronic migraine with a history of failure or progressive ineffectiveness of multiple approved therapies. Given the limited available options, we proposed the patient a 6-week treatment cycle with KOS. After 1 month, monthly migraine days (MMD) dropped from 18 to 7, with significant pain reduction by week 6. However, the benefits were not sustained after discontinuation, requiring a second stimulation cycle after 3 months, which yielded an even faster and more significant response. This experience reveals KOS safety and effectiveness for long-term SPG neuromodulation, highlighting the potential of focusing treatment on the trigeminal-autonomic reflex (TAR) as a promising direction to pursue.