Reading a Migraine Diary: Four Weeks Before Your Appointment
The single piece of preparation that changes a neurology appointment most, and how to keep one without it becoming a chore.
Why four weeks
A month is long enough to show a pattern and short enough that people actually finish it. A prescriber deciding whether a preventive is working needs a baseline, and recall is a poor substitute: severity is remembered far better than frequency, so most people report their worst attacks accurately and their total count badly.
What to record
Five fields, no more:
- Date
- Duration — roughly, in hours
- Severity — mild, moderate, severe
- Treatment taken — what, and how long after onset
- Whether it worked — pain-free at two hours, yes or no
What not to bother with
Elaborate trigger tracking. Triggers are unreliable at the individual level — the prodrome makes a craving look like a cause — and the effort spent on it is usually the reason a diary gets abandoned in week two.
The numbers your prescriber wants
- Monthly headache days
- Monthly acute-treatment days
- Attacks with pain freedom at two hours
Those three numbers do more work in an appointment than any amount of description.