“Eighteen migraine days a month. I had tried four preventive medications, botulinum toxin injections, nerve blocks — nothing sustained. My neurologist was running out of options. When she mentioned leech therapy as an experimental approach, I was desperate enough to try.”
Carlos M., a 39-year-old software engineer from Houston, Texas, describes his experience with investigational leech therapy for refractory chronic migraine, following failure of multiple evidence-based preventive treatments.
Background: Refractory Chronic Migraine
Carlos had suffered episodic migraine since age 22. By age 35, frequency had increased to 18 days/month (meeting criteria for chronic migraine). Neurological evaluation identified a cervicogenic component — cervical muscle tension contributing to migraine triggers. He had failed topiramate (cognitive side effects), amitriptyline (excessive sedation), propranolol (fatigue, exercise intolerance), and valproate (weight gain). Botulinum toxin injections provided 3 months of improvement, then efficacy plateaued.
“I tracked every migraine for years — triggers, duration, severity, medications used. I became the expert on my own disease. But knowing everything about my migraines did not stop them. I was on rescue medication 18 days a month and working maybe 60% of normal capacity.”
Maximum Conventional Treatment
At the time of referral, Carlos was on: onabotulinumtoxinA 155 units every 12 weeks (partial responder), lasmiditan as rescue, plus physical therapy for cervicogenic component. His neurologist considered him a candidate for CGRP monoclonal antibody therapy but wanted to explore adjunctive options given cost and prior incomplete responses.
“My neurologist was thoughtful and honest. She said neurological applications of leech therapy are investigational — not standard of care — but the anti-inflammatory and BDNF-related compounds in leech saliva provided a plausible biological rationale. She would monitor me closely.”
The Leech Therapy Experience
Carlos underwent 6 sessions over 3 months, with leeches applied to cervical paravertebral muscles and the occipital region under ASH practitioner supervision. Sessions every 2 weeks for the first month, then monthly. Anti-inflammatory compounds in leech saliva targeted the cervicogenic component; BDNF modulation provided rationale for central sensitization reduction.
“By month 2, I noticed I was using rescue medication on 10-12 days instead of 18. By month 3, I was down to 7-8 migraine days. That is less than half my baseline. I had not seen that kind of reduction from any preventive medication.”
Frequency Reduction and Quality of Life
Month 1: 18→14 days (22% reduction). Month 2: 14→10 days. Month 3: 10→7 days (61% total reduction). MIDAS score improved from 42 (severe disability) to 18 (moderate). Work productivity improved substantially.
“I still have migraines. I still use rescue medication. But 7 days a month instead of 18 — that is the difference between a life defined by pain and a life where pain is one part of it. I will take that.”
Key Outcomes
Medical Perspective
Treating Physician
Dr. Patricia Nguyen, MD
Neurology, Headache Medicine
“Carlos's case illustrates both the potential and the appropriate caveats for leech therapy in chronic migraine. This is an investigational application — not FDA-cleared for neurological indications. The biological rationale (BDNF modulation, anti-inflammatory eglins, complement inhibition) is mechanistically plausible based on SGS proteomics. The 61% frequency reduction we observed exceeded his best response to any single preventive medication. However, this is a single patient's experience; controlled trials are needed before this can be recommended more broadly.”
Medical Disclaimer
Individual results vary. These stories represent personal experiences and are not guarantees of outcome. Leech therapy requires proper medical supervision. Consult a qualified healthcare provider before starting any treatment.