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. 2015 Apr 1;16:29. doi: 10.1186/s10194-015-0512-x

Table 1.

The data sheet using in the clinical interview

Item Example
Gender Female
Age 43
unilateral Yes
bilateral No
Pain quality Pulsating
Pain intensity 10
Date of headache onset 5/17/2014
Duration of pain episodes 24 hours
Attack frequency 20/month
Attack with fixed period No
The number of attacks 50
Aggravation by or causing avoidance of routine physical activity Yes
Persistent headache, daily from its onset No
Years of smoking 22 years
Years of drinking 0 year
How many cups of tea per day 1
How many cups of coffee per day 0
Family medical history Yes
Location of pain* Crown, Tempus
Precipitating factors* Menstruation
Relieving factors* Stay in dark room
Accompanying symptoms* Photophoby, Phonophobia
Aura* None
Premonitory symptom* Feel weak

*the options of these items are shown in Table 2.