Key takeaways
- A useful migraine log captures onset, duration, severity, associated symptoms, and what you took, not much more.
- Trigger hunting works best in retrospect: log first, look for patterns after two or three months of data.
- Short reaction-time and vision check-ins during the prodrome and postdrome add signal a symptom diary alone misses.
- Bring a one-page trend summary to a headache-clinic visit rather than the raw log.
If you have lived with migraine for any length of time, someone has probably told you to keep a diary. And if you have actually tried, you have probably given up on one within a few weeks. The reason is almost always the same. The forms ask for too much, the writing has to happen when you feel your worst, and by the time you sit down at a headache-clinic appointment you cannot remember whether last Tuesday was a bad four or a bad six. A good migraine log is not a research instrument. It is a habit small enough to survive a real attack, and structured enough that a clinician can look at three months of it and see something.
What to actually log during an attack
The temptation is to record everything. Resist it. The fields that turn out to be most useful, month after month, are boring and short: the date, the time you first noticed something was off, the time the pain became the main event, how long the attack lasted, the peak severity on a simple zero to ten scale, and a short list of associated features (aura, nausea, sensitivity to light or sound, dizziness). Add what you took, when, and whether it worked. That is roughly seven fields. It is the difference between a log you keep and a log you abandon.
- Date and rough time of the earliest warning sign
- Time the headache became the dominant symptom
- Peak severity on a 0-10 scale
- Duration in hours (estimate is fine)
- Associated features (aura, nausea, photophobia, phonophobia, vertigo)
- Medication taken, dose, and time
- One or two words about how it resolved
The prodrome and postdrome matter more than people think
The headache phase gets all the attention, but many people can look back and notice a prodrome hours or even a day before: yawning that will not stop, a strange food craving, a mood shift, blurred thinking, sensitivity to smells. The postdrome, that day-after fog when the pain is gone but you cannot focus, is often the phase that actually costs you a workday. If you log only the peak, you miss most of the burden. A single line noting how you felt the evening before and the morning after is worth more than an elaborate pain scale.
Trigger hunting: log first, look for patterns later
Almost every migraine patient has a mental list of triggers. Almost every list is partly wrong. Triggers are notoriously hard to identify in the moment because attacks often start well before the perceived trigger, and because the prodrome can create the very craving (sugar, caffeine, alcohol) later blamed for the attack. The way to actually find your patterns is to log neutrally for two or three months and then look back. Sleep timing, menstrual cycle, work stress, weather changes, and screen-heavy days tend to be more reliable signals than any single food. A headache specialist reading your log wants to see a pattern, not a suspect.
- Prodrome
- The early phase before the headache begins, sometimes hours to a day beforehand, when subtle warning signs such as mood shifts, food cravings, yawning, or blurred thinking appear.
Short cognitive check-ins add signal a diary misses
Migraine is a neurologic condition, not just a pain condition. Processing speed, reaction time, and visual sensitivity all shift during and around an attack, and those shifts are measurable well before you would think to write anything down. Running a two-minute reaction-and-processing-speed session on a normal day, and again during a prodrome or postdrome, gives you an objective number to sit alongside your zero to ten rating. Over months, the trend line tells you how much of your life the postdrome is actually eating.
For anyone who gets visual aura, or who suspects post-concussive overlap after a head injury, an eye-brain vision check adds another useful layer. Both assessments are short by design, because the last thing anyone wants during a migraine is a long test. See the reaction and processing speed and eye-brain vision check pages for how these sessions are structured.
Paper, spreadsheet, or app: it barely matters
The best format is the one you will still be using in ninety days. A folded index card by the bed works. A note on the phone works. What matters is that the same fields are captured every time, so that three months of data can actually be compared. If you switch tools every few weeks, you lose the comparability, which is the whole point.
What to bring to a headache clinic
Do not hand over the raw log. Summarize. One page with the number of attack days per month for the last three months, the average and peak severity, typical duration, most common associated features, what you have tried, and what worked. If you have been running short cognitive check-ins, include the trend, not the individual sessions. A specialist can act on a summary in five minutes. A three-month journal takes an entire visit to read.
How Alumina Health fits in
Alumina Health does not replace a headache diary and does not diagnose migraine. It provides short, guided reaction-time, processing-speed, and vision check-ins that can sit alongside a simple log, so the neurological cost of an attack is visible in something more objective than a memory of how hard the week felt. Bring the trend summary to a neurologist or headache specialist, and let them make the clinical calls.