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The migraine report your neurologist actually wants

A neurology appointment lasts maybe fifteen minutes. What fills it — vague recollection or three months of dated evidence — is largely up to what you walk in holding.

Updated August 2026 · 6 min read

The four numbers that drive decisions

Strip away everything else, and migraine consultations turn on a handful of figures. If your record produces these, it has done its job:

• Headache days per month. The headline number. It separates episodic from chronic migraine — the commonly used threshold is 15 or more headache days a month — and it's the yardstick by which any preventive treatment will later be judged. Our guide to counting headache days goes deeper on why this metric rules everything.
• Medication days per month. Not doses — days on which you took any acute medication. This is the number that flags medication overuse headache risk, and it's the one patients most consistently underestimate from memory.
• Typical intensity and duration. How bad, how long, and how much of life stops. This shapes how aggressive a treatment plan is worth being.
• Patterns. Attacks clustering before a period, after weekends, around weather fronts or short nights. Patterns can point toward specific strategies — and a documented absence of patterns is informative too.

Why recall fails in the exam room

"How many headache days did you have last month?" sounds answerable until a clinician actually asks it. Research on symptom recall shows people compress and distort: severe recent attacks crowd out mild older ones, "a few times a week" gets rounded to a story rather than a count, and medication use is remembered as less frequent than it was. Add the mild stage fright of a specialist appointment and a ticking clock, and even articulate patients deliver estimates that are off by half.

The consequences are not cosmetic. Undercount your headache days and you may look episodic when you're chronic, closing the door on treatments you qualify for. Undercount medication days and a developing overuse cycle stays invisible. The American Migraine Foundation recommends diary records precisely because treatment decisions need counts, not impressions.

What three months on paper changes

Hand over a dated three-month summary and the appointment inverts. Instead of spending ten minutes reconstructing your history through questions, the clinician spends one minute reading it and the remaining time on what to do — diagnosis, prevention options, whether your acute medication pattern needs attention. Patients who bring records consistently report a different kind of conversation: fewer "roughly how often" questions, more "I can see that, so let's try this."

Three months is the meaningful window for a first visit or a treatment review. It's long enough for monthly averages to stabilize, long enough to catch a cycle-linked pattern three times over, and it mirrors the period over which many preventive treatments are typically evaluated. Longer histories help for follow-ups — showing a before/after around a medication change is the clearest possible evidence of whether it worked.

Getting the report without doing the maths

You can build this by hand: keep a consistent diary, then before the appointment tally headache days and medication days per month, note your typical severity, and write a line about any patterns. It works; it's also the step where good diaries stall the night before an appointment.

Dim collapses that step to one tap. Because every attack is logged with its timestamp, intensity and medication, the app can generate a doctor-ready PDF of your full history — headache days per month, acute-medication days with an overuse flag when the count runs high, intensity distribution, and the weather, pressure and sleep context it captured automatically alongside each attack. Prefer to run your own analysis or attach raw data to a health record? The same history exports as CSV. Both stay on your device and your private iCloud until you choose to share them; there's no account and nothing is sent anywhere.

However you produce it, the principle holds: the report is short, the numbers are counted rather than recalled, and the appointment time gets spent on decisions instead of archaeology. If you want help with the visit itself, see our checklist for preparing for a neurologist appointment.

Your history, one tap from the printer

Dim turns months of three-tap logs into a doctor-ready PDF or CSV — headache days, medication days, patterns and context included.

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