When temperatures fall, Debbie Kutner can count on her peripheral neuropathy symptoms worsening. She feels more numbness and pain in her feet and cramps in her toes. “I've actually tracked it and watched it, and there's no question that cold weather makes this disease more uncomfortable for me,” says the 73-year-old retired physical education teacher in Nashville. If the barometric pressure drops, as it does before a storm, Kutner, who was diagnosed with the nerve condition five years ago, finds walking difficult.
Many aspects of weather—including barometric pressure fluctuations and hot and cold temperatures—can affect people with neurologic conditions, says Alise Carlson, MD, a staff neurologist at the Cleveland Clinic. “We know that temperature extremes and variability are associated with increased incidence of stroke, migraine headaches that are more severe, and higher hospitalization rates for people with dementia,” she says.
Melyza Casanova developed migraine in 2017 and treats it effectively with two daily medications. In the past two or three years, though, she's experienced more severe attacks due to barometric pressure changes. A tingle that starts in her nose and works its way up her sinuses acts as an alarm. “It's so [reliable] that my husband depends on me to tell him when it's going to rain,” says Casanova, 46, a grant manager at the University of Miami.
Heat is especially worrisome for older people or people with dementia or Alzheimer's disease, says Nancy L. Sicotte, MD, FAAN, chair of the neurology department at Cedars-Sinai Medical Center in Los Angeles. “They may have trouble coping or feel more brain fog when it's hot,” she says.
People with multiple sclerosis are also vulnerable, says Dr. Carlson, because heat can cause electrical signals to slow due to the damage MS does to nerves’ protective, insulating covering. Hot weather might trigger symptoms such as weakness, abnormal sensations, visual disturbances (including blurred or double vision), swelling, cognitive problems, and poor coordination, she says.
Worsening symptoms don't happen at a specific temperature, Dr. Carlson says, “but longer exposures to higher levels of heat are more often associated with them.” High temperatures also can disrupt sleep, and for people with MS, poor sleep may affect cognitive function the following day. MS symptoms related to the heat usually last less than 24 hours, says Dr. Carlson. “People experiencing completely new symptoms or those lasting more than 24 hours should visit their neurologists,” she says.
Bright sunlight, humidity, sun glare, dry air, and wind can trigger migraine attacks, according to the American Migraine Foundation. “Migraine is a sensory perceptual disorder with hypersensitivities to both internal and external stimulation, including changes in barometric pressure,” says Teshamae Monteith, MD, FAAN, associate professor of neurology at the University of Miami Miller School of Medicine.
When Casanova feels a storm coming on, she takes a migraine medication. “If I'm at work, I'll take one of my ‘bazookas’—sumatriptan [Imitrex]—which kicks in within an hour,” Casanova says. “At home, I put myself to bed.”
Stormy weather increases pain exponentially for Gerry Nangle, 73, a member of the clergy in Tucson. She has peripheral neuropathy and dysautonomia, a nervous-system disorder that can affect involuntary bodily functions such as breathing, heart rate, and blood pressure. Lower barometric pressure causes tightness in her torso and back and heaviness in her shoulders and legs, while high temperatures can result in burning sensations in her legs and feet, Nangle says.
In addition to exacerbating symptoms for people with neurologic conditions, changing climate and weather patterns could expose anybody to more airborne pollutants, which have been associated with an increased risk of dementia and Parkinson's disease, stroke, and worsening MS symptoms, says Dr. Carlson. Diseases spread by insects, such as Lyme (caused by ticks) and West Nile virus (mosquitoes), may become more prevalent, since hotter temperatures promote some insects’ survival, she adds.
“We might be seeing changes in patterns of infectious disease that cause neurologic symptoms,” Dr. Carlson says. She and other neurologists recently published an article in the journal Neurology calling for further study of how climate change affects the severity of neurologic disease to help doctors mitigate the impact for their patients.
In the meantime, people with neurologic disorders can take action to minimize the weather's effect on their conditions. If heat exacerbates symptoms, stay indoors where it's cooler or air-conditioned, whether at home or in a public place such as a senior center, library, or movie theater, advises Dr. Sicotte. If you must go out, wear a hat and try to stay in the shade, she adds.
Heat also can lead to dehydration, and that can worsen neurologic symptoms or even increase the risk of stroke and headache. Drink lots of water to stay hydrated, even when you don't feel thirsty, Dr. Sicotte says. Drinking water cools the body and keeps blood volume at the appropriate level, preventing neurologic symptoms from worsening. “Tracking water [consumption] on an app may be helpful for some people,” Dr. Carlson says.
If your home doesn't have central air-conditioning, consider installing a window unit in the bedroom to help you sleep better on hot nights, and check with your state or your electricity provider about possible rebates or discounts for people who need equipment such as an air conditioner for medical reasons.
Clothing also can keep you more comfortable. When it's hot, try a cooling vest, headband, or wrist wrap that is kept in the freezer before it is worn. In cold weather, carry gloves, extra socks, and an additional sweater “so you can layer and adjust and do some of that temperature regulating your body normally does,” says Dr. Carlson.
Kutner has grown more accepting of how weather affects her symptoms. “I've fretted over this whole issue for years,” she says. “Now I just work through it and remind myself that it will go away.”
