What Your Doctor Actually Wants to See in a Headache Diary
Neurologists have about 10 minutes per appointment. Here is the one-page summary that makes your migraine history readable in 60 seconds — and changes your treatment.
Why a thick diary is the wrong thing to bring
A neurology appointment is short — often around 10 minutes — and a doctor cannot read 90 days of daily notes during it. The single most common mistake migraine patients make is bringing a detailed diary that no one has time to read. What changes your treatment is not the raw diary; it is a one-page summary your doctor can absorb in 60 seconds.
The daily tracking still matters — but as the raw material for the summary, not as the thing you hand over.
The five numbers a neurologist looks for
When deciding whether to start, stop, or change a preventive, doctors are looking for a small, specific set of figures:
- Migraine days per month — and the trend versus previous months. This single number decides whether you meet the threshold for preventive treatment (often around 4+ migraine days per month).
- Acute medication days per month — to check for medication overuse risk (10+ days for triptans, 15+ for simple painkillers). See our guide on MOH.
- Attack severity and duration — typical pain level and how long attacks last, including whether acute treatment works.
- Your most likely triggers — the 2–3 patterns your data actually supports, not a guess.
- Any cycle or hormonal pattern — whether attacks cluster around menstruation (the menstrual window).
If your summary answers these five, the appointment is productive. If it does not, the doctor spends the visit extracting them from you instead of treating you.
What a good one-page summary looks like
A useful doctor summary fits on a single sheet and contains:
- A headline count: migraine days this month and the 3-month trend
- A medication-day count with the MOH thresholds marked
- Top 3 suspected triggers from your tracked data
- A note on any menstrual/hormonal clustering
- Current medications and whether they are helping
That is it. Everything else is supporting detail you can offer if asked.
How to prepare for the appointment
- Track daily for at least 4–8 weeks before the visit — one month is the minimum for a believable trend.
- Fill in the summary page the day before the appointment, not during it.
- Bring the summary on paper. It is faster to scan, and the doctor can mark it up and keep a copy.
How Trackwell builds the summary for you
The Trackwell migraine tracker is designed backwards from this appointment. The daily pages feed a built-in doctor visit summary: migraine-day count, medication-day count with an MOH risk bar, your top triggers, and the menstrual pattern matrix — all on one printable page.
If you want to try the structure first, download the free 1-month sample →. No payment, no account.