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Managing Pain 2019

The benefits of a migraine diary

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Dr Martin Ruttledge

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

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Dr Mary Kearney

GP and co-author of the Migraine Quick Reference Guide

Migraine is the most common headache disorder seen by doctors. 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.


The ICGP Migraine Quick Reference Guide, which was co-authored by Dr Ruttledge, Dr Mary Kearney and Ms Esther Tomkins 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. 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. 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.

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

At the launch of the ICGP Migraine Quick Reference Guide, which was co-authored by Dr Ruttledge, Dr Mary Kearney and Ms Esther Tomkins, 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 migraineurs in Ireland.”

The more detailed the diary, the better

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

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. The diary should include, at the least, symptoms, duration, severity, medication taken and its effect for each attack.”[3]

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


[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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