Whether generated by patients or clinicians, the headache diaries I have reviewed over the years often have seemed to me incomprehensibly elaborate. Featured here is the “simple but sweet” diary we have been using at our center for over a decade. From this diary, one can calculate “headache days” per month and “functionally incapacitating headache days” per month (ie, 3s), as well as obtain some idea whether the patient may be overusing acute medications. We use this diary to calculate a “headache profile” for each patient (eg, 17/7 would mean that over the month in question, the patient had experienced 17 days of headache, 7 of which involved functionally incapacitating head pain). If we have an interest in determining whether the patient may have menstrually associated migraine and wish to assess the temporal association of headache and menses, we simply ask her to indicate on the diary when menstrual flow commenced and when it ceased.
John F. Rothrock, MD
University of South Alabama Headache Center