What to write in a headache diary for your neurologist

For each headache, write down the date, when it started and how long it lasted, how strong it was (0 to 10), the symptoms around it, any medicine you took with its dose and whether it helped, and anything you suspect played a part. Across the month, the two numbers your neurologist will look at first are how many days you had a headache and on how many days you took acute medication.

Facts checked on · Written by Alfonso Matos, the developer of MyGrain.

For every episode

  • Date and start time. Also log the days without pain if your doctor asks for it: they make the count of headache days reliable.
  • Duration, until the pain was gone.
  • Intensity on a 0–10 scale, or mild, moderate or severe — use the same scale every time.
  • Type of headache if you already have a diagnosis (for example migraine with or without aura, or tension-type headache).
  • Symptoms: nausea or vomiting, sensitivity to light or sound, visual or other aura symptoms, and what you noticed in the hours before.
  • Medication: name, dose, time, and whether it helped.
  • Impact: did you miss work, school or plans?
  • Possible triggers you noticed: sleep, stress, meals, alcohol, weather, screens.
  • Menstrual cycle, if it applies: the first day of each period.

The days you take acute medication

Count the days per month on which you took any painkiller or migraine medicine for an attack, not only the number of tablets. The International Classification of Headache Disorders (ICHD-3) describes medication-overuse headache: headache on 15 or more days a month in someone with a pre-existing headache disorder, which develops with regular overuse of acute medication for more than three months. What counts as overuse depends on the type of medicine; for triptans, for example, the classification uses intake on 10 or more days a month.

This is not something to judge on your own, and it is not a reason to stop or change any medicine without medical advice. It is the reason a neurologist asks for that count: write it down and let them interpret it.

Possible triggers: notes, not conclusions

Note what happened before an attack, but treat it as an observation. Something that appears often before your attacks may also be frequent on days without pain. Your doctor can help you decide what is worth testing.

How long to keep it

Headache specialists usually ask for several weeks of entries before an appointment; follow what your own doctor asks for. Consistency matters more than detail: a short entry every day is more useful than a long one now and then.

Paper or app

Both work. Paper is simple; an app counts the days for you and can produce a summary. MyGrain, for example, records type, intensity, duration, symptoms, triggers and treatments, keeps a colour-coded calendar, and with Premium exports the month as a PDF to share with your neurologist. It does not diagnose and does not tell you what causes your attacks.

Frequently asked questions

How many days of medication count as overuse?

The ICHD-3 classification sets different thresholds by type of medicine — for triptans it uses 10 or more days a month for more than three months. Only your doctor can assess your case; keep the count and bring it to the appointment.

Should I log days without a headache?

If your doctor asks for it, yes. Pain-free days make the monthly count of headache days unambiguous.

Can I add a migraine I forgot to log?

Yes, write it down as soon as you remember, with the right date. In MyGrain you tap the day on the calendar and the entry is created for that date.

Sources

Store listings and official websites, all checked on .

Medical disclaimer. MyGrain is a self-tracking diary, not a medical device. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your doctor or another qualified health professional with any question about a medical condition.
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