The same 5-question test neurologists use to determine treatment eligibility for Botox and CGRP therapies. Calculate your Grade I–IV score instantly — no signup required.
The MIDAS (Migraine Disability Assessment) is a clinically validated questionnaire developed by Dr. Richard Lipton and Dr. Walter Stewart. It measures productivity lost to migraine over the past 90 days across three domains: work/school, household chores, and social or family activities.
Neurologists rely on MIDAS scores to decide between treatment tiers. A Grade IV score (21+) is often the clinical threshold for prescribing preventive therapies like OnabotulinumtoxinA (Botox injections) or CGRP monoclonal antibodies (Aimovig, Emgality, Ajovy).
Many patients underestimate their migraine burden when speaking with doctors. A calculated MIDAS score provides objective evidence that can unlock access to newer, more effective treatments. The Relief iOS app lets you track MIDAS over time and generate signed PDF reports to bring to your neurologist.
How many days in the last 3 months did you miss work or school because of your headaches?
How many days was your productivity at work or school reduced by half or more?
How many days did you not do household work (chores, errands, cooking)?
How many days was your household productivity reduced by half or more?
How many days did you miss family, social, or leisure activities?
Track your MIDAS score over time and generate a signed PDF report for your neurologist:
Download Relief — FreeSupplemental (not scored): The standard MIDAS also includes questions about headache frequency and average intensity (0–10 scale). These provide context but don't affect the score. The Relief app captures these automatically from your logs.
Grade I (0–5 points) indicates that migraines cause little or no disruption to your daily life. Most neurologists recommend lifestyle modifications and acute rescue medications at this level.
Grade II (6–10 points) suggests mild disability. Your doctor may consider a daily preventive medication if your attacks are frequent or particularly severe despite a lower disability score.
Grade III (11–20 points) reflects moderate disability. At this level, a combination of preventive and acute therapies is typically recommended, along with trigger management strategies.
Grade IV (21+ points) indicates severe disability. This score often qualifies patients for advanced treatments including Botox (OnabotulinumtoxinA), CGRP monoclonal antibodies (Aimovig, Emgality, Ajovy), or CGRP receptor antagonists (Nurtec, Ubrelvy).
Neurologists recommend reassessing your MIDAS score every 3 months to track treatment effectiveness. A decreasing score indicates that your current treatment plan is working. An increasing score signals the need for a treatment adjustment.
Many patients struggle to communicate the true impact of migraines during a short appointment. A MIDAS score provides objective, quantified evidence of disability that helps your neurologist make faster, more accurate treatment decisions. The Relief app generates a signed PDF report you can share directly with your healthcare provider.
The Relief app lets you retake MIDAS every 3 months, track trends, and export signed PDF reports for your neurologist — all free.
Download FreeRelief for iOS