pediatric headache diary pdf

Headache caffeine diet soda chocolate hot dogs food with artificial sweeteners processed foods Important Stressful. Headache diary helps doctors decide about the diagnosis and management.

Keeping a headache diary is very important to help track progress in managing headaches.

. HEADACHE DIARY DUPLICATE AS NEEDED DATE TIME BEGAN TIME ENDED TRIGGERS SYMPTOMS 1-photophobia 2- phonophobia 3- nausea 4- vomiting 5- dizziness OTHER. HOLYOKE PEDIATRIC ASSOCIATES LLP 150 Lower Westfield Road 84 Willimansett Street Holyoke MA 01040 South Hadley MA 01075 413 536-2393 413 532-0300 HEADACHE. Headaches are common in children 3 for ages 3-7 years and even more so in adolescents.

This information will help you and your healthcare provider learn about your headaches. Please make sure that IF you need glasses or a new prescription that you have the correct. Headache Diary Date.

A headache diary can include information on a range of things however its often best to keep it simple and record basic information. To learn more about headaches we invite you to read our headaches page. Page 1 is the diary Page 2 is the key Pages can be printed separatel y if you need multiple copies of the diary but only one copy of the key - just select in the box that comes up.

352009 100251 PM. Keeping a headache diary may help you understand what types of headaches you get and what treatment. Scans of the head do not help in the diagnosis of migraine.

List all other foods eaten within 6-12 hours prior to headache onset 1. Medication-oeruse v headache MOH Headache occurring on 15 or more days per month developing as a consequence of regular overuse of acute or symptom-atic headache. DATE TIME startfinish INTENSITY rate 1 -10 most severe being 10 PRECEDING SYMPTOMS TRIGGERS.

Time of Headache Time Headache Ended. Angela Lassetter Created Date. Headaches in Children - 2 - spots in vision difficulty moving or with balance or tingling of a body part.

Type of Pain pressing throbbing piercing etc. Warning Signs aura Medication time and dosage Stressors. Stress mood changes dehydration and lack of sufficient sleep may contribute to.

Headache Diary Print this form so that you can track your headaches for a month. Write down the following details about your headache. This will also help you and your health provider make a plan for.

Please list what makes it BETTER and what makes it WORSE. Headache make notes in your diary. Please list the TIME and DATE the headache STOPS.

Headache Diary Date time started Severity Headache Triggers Relief Measures Other comments. Keeping a headache diary may help you learn more about your childs situation. It helps the doctor be able to treat them.

Severe headache impairing ability to function- Not able to go to school play or do enjoyable activitiesNeed to lay down and rest. Use a separate line for. Warning Signs aura Location of Pain.

A headache diary consists of tracking the following information. HEADACHE DIARY Keep track of your headaches. Children and adolescents ages 3-21 years whose chief complaint is headache.

Record the number of headaches you had during this day. Please fill out the diary every day on which you experience any head. A Headache diary is useful to record.

Moderate headache not impairing. Day of the week. Please list TIME and DATE the headache STARTS.

Can be on a piece of paper calendar or for smart phone uses try a migraine tracking app o. 50 Printable Headache Diary Templates Word Pdf Printabletemplates Moderate headache not impairing. Headache TimeDuration startfinish Location of pain Intensity of pain on a scale of 1 to 10 10 being the worst Activities or.

The Boston Childrens Hospital. Print this migraine andor headache diary and use it to keep track of your headaches or migraines. Please fill out the diary every day on which you experience any head pain and remember to bring it in.

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