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From the Cleveland Clinic: Migraine Headache Diary

Medical Information from the Cleveland Clinic
Migraines & Headaches

Migraine Headache Diary

Print this diary and use it to keep track of your headaches.

Date
Time Headache Began
Time headache Ended
Warning Signs (aura)
Location of Pain
Type of Pain (pressing, throbbing, piercing, etc.)
Intensity of Pain* (circle one number to the right) 1 2 3 4 5
6 7 8 9 10 		1 2 3 4 5
6 7 8 9 10 		1 2 3 4 5
6 7 8 9 10 		1 2 3 4 5
6 7 8 9 10
Other Symptoms (nausea, vomiting)
Medication Taken/ Other Treatment
Effect of Treatment
How Headache Affected My Normal Routine
Hours of Sleep the Night Before the Headache
What I Ate Before the Headache (caffeine, diet soda, chocolate, hot dogs, food with artificial sweeteners, processed foods)
Activities Before Headache Occurred
Important or Stressful Events That Occurred Today
Comments

Reviewed by Department of Neurology, Department of Pediatric Neurology, The Cleveland Clinic.

Medically reviewed by Charlotte E. Grayson, MD, June 2004, WebMD.

How often do you experience migraines?

  • Rarely
  • Once or twice a month
  • Three times a month
  • More frequently than three times a month