What is the best way of keeping a migraine diary?


A migraine diary can be simple or very detailed, so using an app can be a timesaver. Don’t let your life be all about migraine.A migraine diary can be simple or very detailed, so using an app can be a timesaver. Don’t let your life be all about migraine.


“There's many different ways you can keep a headache diary. Now in the world of apps and all of our smartphones, many individuals like to do different types of apps that are available. One that a lot of my patients will use is one called Migraine Buddy. In that, you can put in as much information as you want or as little information as you want. Typically, you're recording the days that you have a headache or the days that you have kind of what they call a full-blown migraine attack, what a lot of my patients will say. In general, my patients will report only the days that they have a headache or a migraine attack. Sometimes other patients, even if they don't have head pain, they may not feel well and so they'll keep track of those things too, because that might actually be what we call a prodrome. So in a migraine attack there may be a prodrome, so symptoms that occur several hours or days, that may be neck pain or fatigue and sometimes people have increased urination, cravings, hunger, etc. Then sometimes patients will have an aura phase, where they'll have visual, sensory, or speech symptoms. Then the migraine attack, which usually encompasses pain, sensitivity to light, sound, smell, exacerbation of the pain with movement. Then sometimes patients will have a postdrome. Patients like to call that the migraine hangover. Whether those phases actually involve pain or not they‘re all a part of the migraine attack. So patients may actually record those things in a headache diary.
“Initially we had this huge paper diary. The one that we have is like, this large, and I couldn't imagine how people would carry this around. What I found after several years of practice was, people weren't carrying it around and weren't keeping track of it and weren't bringing it in to their appointments. You can spend as much time or as little time on a headache diary. I actually like for patients to spend as little time as possible because I don't want their life to become all about migraine. I don't want them to always engage in migraine pain behaviors, I want them to engage in life behaviors and migraine life behaviors. I like apps and different diaries that allow you to put as little or as much information as you want. Which is why I like the one Migraine Buddy, because if all you want to do is record that you had a headache on that day, that's all you have to record.”


An app like Migraine Buddy helps you keep a diary with as much or as little detail as you want. Don’t spend too much time on it to keep the focus on life behaviors, not migraine pain behaviors.

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Amaal J. Starling, MD, FAHS, FAAN

Mayo Clinic, Arizona

Dr. Amaal J. Starling is an associate professor of neurology at the Mayo Clinic College of Medicine. She joined the Mayo Clinic in 2012 and is currently a consultant within the Department of Neurology. Dr. Starling received her medical degree from the Drexel University College of Medicine in Philadelphia. She completed a transitional year residency, a neurology residency, and a headache fellowship at the Mayo Clinic College of Medicine in Scottsdale, Ariz.

Dr. Starling is an active member of numerous migraine advocacy organizations, including the American Headache Society (AHS), the American Migraine Foundation, and the American Academy of Neurology (AAN). She is also involved in events supporting migraine, including Headache on the Hill, Miles for Migraine, and the Alliance for Headache Disorders Advocacy. Dr. Starling is currently serving on the AHS Board of Directors and is the chair of the AHS Advocacy Committee and a member of the AHS Diversity, Equity, and Inclusion Taskforce. Dr. Starling has been the recipient of numerous awards, including the AHS Above and Beyond Award for Service, Manfred D. Muenter Award for Excellence in Clinical Neurology, the AAN Annual Meeting Residency Scholarship, the 2012 Spirit of Mayo Clinic Award, and the Mayo Brothers Distinguished Fellowship Award.

Dr. Starling has authored numerous peer-reviewed publications and abstracts related to her fields of interest, which include migraine, concussion, post-traumatic headache, neuromodulation, and telemedicine. Dr. Starling’s hope is that her research and advocacy will advance care for people with migraine, post-traumatic headache, and other headache disorders. She envisions a future in which all people with headache disorders receive personalized, effective, and well-tolerated treatment options to improve their quality of life.

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Amaal J. Starling, MD, FAHS, FAAN