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Managing Pain 2019

The benefits of a migraine diary from the migraine quick reference guide

Dr Martin Ruttledge

Consultant Neurologist, Beaumont Hospital, Dublin, Ireland MB, BCH BAO, Dr Med Sc

Dr Mary Kearney

GP and co-author of the Migraine Quick Reference Guide

Doctors often see headache disorders, with migraine being one of the most common. For this reason, it is estimated to cost the Irish economy €252 million a year[1]. A migraine diary can be hugely beneficial to patients and their healthcare providers.

Dr Ruttledge, Dr Mary Kearney and Ms Esther Tomkins co-authored The ICGP Migraine Quick Reference Guide. In fact, this reference guide was developed to “help give doctors a greater understanding of migraine, and improved tools in the assessment of headaches which will help them identify cause of headache,” says GP Dr Mary Kearney.

The peak prevalence is for women between the ages of 15-49 years. Additionally, the life-time prevalence is 42% in females[2]. Some patients experience relatively infrequent attacks during their lifetime, while the average patient gets one to two attacks per month. Additionally, approximately 10% of all patients get weekly attacks.

The diary should include, at the least, symptoms, duration, severity, medication taken and its effect for each attack.

Underdiagnosed and undertreated

Furthermore “migraine is a very common and often debilitating neurological disorder. Although sadly, doctors and healthcare professionals worldwide underdiagnosed/undertreated migraine.” says Dr Martin Ruttledge, Consultant Neurologist at Beaumont Hospital.

At the launch of the ICGP Migraine Quick Reference Guide, Dr Ruttledge said: “Our statistics are getting worse and worse as time goes on. We think there’s probably about three quarters of a million migraine patients in Ireland”. It was co-authored by which was co-authored by Dr Ruttledge, Dr Mary Kearney and Ms Esther Tomkins.

The more detailed the diary, the better

“When a patient presents to a general practitioner with recurrent headaches, they should be advised to keep a detailed daily diary. However, ensure that these include details about the severity of the headaches, associated features, acute treatments used, effect on lifestyle and possible triggers.” ICGP Migraine Quick Reference Guide says.

Furthermore, this provides very useful clinical information and can help confirm the diagnosis. In addition, the diary often demonstrates the benefits of acute and/or other therapies. In short, the diary should include, at the least, symptoms, duration, severity, medication taken. Similarly it’s to reference its effect for each attack.”[3]

Generally speaking, Dr Ruttledge concludes. “It’s all about just sitting and talking to the patients”.

[1] Steiner TJ, Stovner LJ, Vos T, Jensen R, Katsarava Z. Migraine is first cause of disability in under 50s: will health politicians now take notice? J Headache Pain 2018 Feb 21; 19(1):17-018-0846-2.
[2] Frederick IO, Qiu C, Enquobahrie DA, Aurora SK, Peterlin BL, Gelaye B, et al. Lifetime prevalence and correlates of migraine among women in a pacific northwest pregnancy cohort study. Headache 2014 Apr; 54(4):675-685.
[3] Migraine Diagnosis & Management from a GP Perspective Quick Reference Guide

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