A migraine diary is a simple record of when headaches happen, what they feel like, which symptoms accompany them, and how medication affects them. Before seeing a neurologist, record headache dates, timing, severity, symptoms, medication use, and effects on daily activities. Short, consistent notes are more useful than a detailed journal that becomes difficult to maintain.
This information helps your neurologist understand headache patterns and treatment response without relying entirely on memory. A diary supports the evaluation, but it does not diagnose migraine by itself. You do not need to identify a cause or decide which type of headache you have before your appointment.
Choose a format you can keep using
A notebook, printable calendar, spreadsheet, or app can work. Choose whichever is easiest to access when you need it. The American Migraine Foundation explains that headache tracking can take several forms and should not become an overwhelming task.
Use brief notes or familiar abbreviations. If pain makes writing difficult, record the basics when you feel able. Approximate times are fine when you cannot remember exactly. Mark missing information as unknown rather than guessing.
Record the details that describe your headaches
The Migraine Trust’s diary guidance recommends recording dates, duration, severity, associated symptoms, medication, and relevant context. The following checklist offers a practical way to organize those details.
| What to record | Helpful details |
|---|---|
| Date and timing | When the headache started, when it ended, and whether it continued into another day. |
| Pain severity | Use the same scale each time, such as 0–10, with 0 meaning no pain and 10 the worst pain imaginable. |
| Location and feeling | One side, both sides, behind an eye, or elsewhere; throbbing, pressure, sharp, or another description. |
| Other symptoms | Nausea, vomiting, dizziness, or sensitivity to light and sound. |
| Symptoms around the headache | Describe changes before, during, or afterward, including visual changes, tingling, fatigue, or difficulty concentrating. Include their timing. |
| Medication and response | Name, dose, time taken, repeat doses, relief noticed, whether pain returned, and possible side effects. |
| Daily impact | Missed work, interrupted sleep, canceled plans, or difficulty completing household responsibilities. |
Aura means temporary neurological symptoms, often involving vision or sensation. If you experience something that might be aura, describe exactly what happened and how long it lasted instead of simply writing “aura.” New or sudden neurological symptoms need urgent assessment, as explained below.
For daily impact, concrete notes help: “left work two hours early” or “could not finish dinner preparations” gives more information than “bad day.”
Count headache days separately from episodes
Include every headache day, including mild headaches, rather than only the most severe attacks. The National Migraine Centre’s diary instructions recommend recording every migraine or other headache and documenting repeat medication doses.
For a simple calendar summary, count dates rather than diary entries:
- Headache days: Mark each calendar date on which you had head pain. Two episodes on Tuesday still count as one headache day. A headache continuing through Tuesday and Wednesday affects two headache days.
- Medication-use days: Mark each date on which you took medicine to relieve an attack. Two doses on Tuesday count as one medication-use day, although both doses should appear in your notes.
- Different medicines: Record each medicine separately. Taking two different attack medicines on Tuesday still counts as one date in your overall medication-use total.
Keep daily preventive medicines, taken to reduce future attacks, clearly labeled separately from medicines used for immediate relief. A brief “no headache” entry can distinguish a headache-free day from a missed entry.
Medication-use days matter because frequent use of certain headache medicines can contribute to medication-overuse headache, in which headaches develop or worsen with repeated use. Risk depends on the medicine and the pattern over time. Do not stop, increase, or change medication on your own; bring the record to your clinician.
Note context without assuming it caused the attack
If useful, add a short note about unusual sleep, a missed meal, a change in caffeine intake, stress, or menstrual timing. You do not need to document every food, activity, or environmental detail.
Write “slept five hours” rather than “lack of sleep caused this headache.” Something happening before an attack does not prove it triggered the attack. The American Migraine Foundation explains that identifying triggers can be complicated; some apparent triggers, such as food cravings, may actually be early symptoms.
Avoid creating food restrictions based on a single entry. Look for repeated observations to discuss with your neurologist. If tracking becomes stressful, simplify it to timing, symptoms, medication, and impact.
A fictional sample entry
Fictional example, not a real patient story: October 4, 9 a.m.–2 p.m. Right-sided throbbing pain, worst severity 7/10. Nausea and light sensitivity; no visual changes. Left work early. Medication name and dose copied from label, taken at 9:30 a.m.; partial relief by 11 a.m., no side effects noticed. Slept about five hours the previous night.
Start now and bring what you have
The National Migraine Centre recommends recording a month, or as long as you can before your appointment. Start now, but do not delay an appointment or urgent care to complete a diary. Bring whatever record you have, even if it is incomplete.
For your visit, gather:
- Your diary and, if possible, a summary of headache days and attack-medication days for each month recorded.
- A current medication list, including prescriptions, nonprescription medicines, supplements, doses, and frequency.
- Previous headache treatments, how long you tried them, and any benefit or side effects.
- Your main questions, such as what the pattern suggests and what care options may be appropriate.
Know when symptoms need immediate attention
MedlinePlus identifies headache warning signs that require immediate medical attention. Call 911 or seek emergency care for a sudden explosive or worst-ever headache, or a headache with new weakness, trouble speaking, confusion, loss of balance, or sudden vision changes. Headache with fever and a stiff neck, or following a head injury, also needs urgent evaluation.
Do not assume these symptoms are migraine or wait for an outpatient appointment. Contact a clinician promptly if your usual headaches change in pattern or intensity.
A&B Neurology provides evaluation and care for migraines and headaches. To discuss an evaluation for recurring headaches, contact A&B Neurology in Colleyville at (214) 717-2772.
This content is educational and does not replace personalized medical advice.
