Treatment of Refractory Chronic Migraine with Worm Eggs: A Therapy Rooted in Evolution

Abstract

Introduction: This was a small open label study designed to determine efficacy of helminth egg therapy in refractory chronic migraine (RCM) patients. It is probable that the immune system is involved in migraine. (1) Helminth worms have populated the GI tract of primates for millions of years. They downregulate the immune response. When the helminths (and other parasites) are removed, the result may be an increase in autoimmune illness. The immune system and inflammation are involved in migraine pathophysiology. Study design: Eleven RCM patients were enrolled. After the run-in period, patients ingested the helminth eggs every 2 weeks for 5 months. These eggs were from the pig whipworm, T. suris . The primary endpoint involved the number of moderate or severe headache days per month. The first (run- in) month was compared to the last 2 months of active therapy. Secondary endpoints included disability, depression, anxiety, and quality of life. Results : 5 of 11 patients met the primary endpoint (a reduction in moderateorsevereheadachedaysbyatleast3permonth).Thenumberofmoderateorsevereheadachedaysdecreasedby14,10,8,7,and3inthesepatients.Thepatientswhomettheprimaryendpointallbeganwithessentiallynoclinicaldepressionatbaseline.Disabilitydeclinedinall5patients,asdidanxiety.Qualityoflife(numberofunhealthydayspermonth)improvedin2ofthe5patientswhomettheprimaryendpoint.4of11patientswhocompletedthestudydidnotmeettheprimaryendpoint.1otherpatientdidnotsupplydata,andanotherdiscontinuedtreatmentduetodiarrhea.Analysisoftheirsecondaryendpointsdidnotresultinanydefinitiveconclusionsastowhytheydidnotimprove. Conclusion: This study indicates that there may possibly be a role for helminth therapy in treating refractory chronic migraineurs. 5 of 11 patients did well. This treatment is rooted in evolution. The presence of helminths results in a downregulation of certain aspects ofour immune system. By re-introducinghelminths into the GI system, we may dampen our immune response. This may possibly help in the treatment of conditions that involve the immune system, such as migraine.