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TENS units are all over the place in quality, cost and indication. The over the counter versions sold as massage units have a range of energy delivery options but are mostly designed to stimulate muscle twitches and make you feel like they are doing something. Very imprecise and hard to replicate. Devices like GammaCore use a fixed frequency and allow you to increase the amplitude. They send a retrograde signal up the Vagus nerve. In theory its possible to make a TENS do a similar thing but you would be awfully lucky to get it to work in a manner similar to a dedicated device. I'm not sure the frequencies available in a TENS unit match what GammaCore produces. I would be very cautious on the neck because vagus stimulation can lead to heart arrhythmia and a loss of consciousness (fainting).

Thank you both for the information, that's the kind of thing I was struggling to find online in terms of understanding why one can be safe and the other not. I have edited my opening post to direct readers to the replies highlighting the risks. I read in one of Peter Goadsby's papers that CH are very resistant to placebo effect, so I don't think my recovery so far has been down to that. It may be that, for whatever reason, the psilocybin took longer to reset me this time and that is the true reason for my bout reducing to mere shadows. That is one of the biggest problems with finding these 'home remedies', they're very prone to unforeseen interference. Or it may be that TENS can provide the same results as GammaCore but with much higher risk. Pebblesthecorgi, I am sorry GammaCore did not work out for you. I understand Kings College London finished a preliminary psilocybin trial in 2019 that suggested the drug was well-tolerated by patients, implying that further trials would be easier to authorize. Out of all the treatments over the years I still believe that psilocybin in some form will provide the universal and relatively risk-free relief we all seek.

If you require general anesthesia advise the anesthetist of your clusters. Any decent anesthesia person should be aware of the condition. Ask them if they think its ok to include ketamine and decadron to the anesthetic. Propofol also can be helpful but ketamine is better (in theory at least) Also request to wake up with high flow (10-15 lpm) running in the non rebreather mask. These are rational reasonable requests and should help. Frame the request as a question so it can be their idea ;-)

Thank you for sharing your experience with a TENS unit. GammaCore has been a pretty big disappointment. I personally had an opportunity to give it a good try and found it utterly useless. Others report mixed results but it rare to hear a resounding positive comment. Electrical stimulation has been very popular in many areas of pain and dysfunction and a variety of delivery systems are available (TENS type units, direct contact, using acupuncture needles with signal generator attached and implantable neurostimulators.) The theory with GammaCore is to use the vagus nerve as a conduit to affect whatever events are leading to the vasodilation which may be causing the pain. The placement of the GammaCore is intended to provide focused stimulation to the Vagus nerve. By placing the patches near the jaw and behind your head many different nerves are involved and there may be unintended consequences so caution is advised. Also with nerve stimulation there are several variables that can dramatically effect the outcome including frequency, pulse width, amplitude and intensity. Depending on the settings you can get diffing results. Patch size translates to surface area and you have to be careful if the patches are reduced in size as the energy delivery will be concentrated. Be careful its not a risk free thing you are trying especially in a nerve rich head