UAE at 50 °C: How heatwaves make migraines worse, how to protect yourself

It’s not just sweat, rashes, or discomfort, heatwaves can take a toll on your neurological health.

For people living with conditions like migraines, multiple sclerosis (MS), or epilepsy, high temperatures can significantly worsen symptoms. We spoke with Dr. Sagar Kawale, Consultant Neurologist at Medcare Royal Specialty Hospital, Al Qusais, and Dr. Amir Firouzjaei, Chinese medicine practitioner at Wellth, to better understand how heat acts as a trigger and what signs to watch out for.

The heat can trigger or worsen migraines through several physiological mechanisms. “Heat causes blood vessels to expand (vasodilation), which can contribute to the throbbing pain characteristic of migraines,” explains Dr. Kawale. Add dehydration into the mix, which is common in hot weather, and it compounds the risk, since dehydration reduces blood volume and can upset the brain’s electrolyte balance.

Heat also disrupts sleep patterns—a major migraine trigger—while the hypothalamus, the brain’s temperature regulator, is closely connected to migraine pathways. “So heat stress can directly interact with migraine mechanisms,” he adds.

Science backs this up: A 2016 study titled Neurovascular contributions to migraine: Moving beyond vasodilation, published in The Journal of Headache and Pain, takes a fresh look at what really causes migraines. It points out that while the widening of blood vessels (vasodilation) might not be essential to triggering a migraine, the blood vessels still play a key role. How: Through a complex back-and-forth with the nervous system—blood vessels release certain chemicals that can affect nearby nerves, and the nerves, in turn, can influence the blood vessels. The takeaway: To truly understand migraines, we need to look at both the vascular and neural systems together.

A 2013 study published in Current Pain and Headache Reports reviews various environmental triggers that can provoke migraine attacks, especially in individuals already prone to migraines. Among the most commonly reported triggers are heat exposure and dehydration. The study showed how dehydration can lead to changes in blood volume and electrolyte balance, which may disrupt brain function and increase the likelihood of a migraine. Heat can also trigger migraines either directly, by affecting thermoregulatory processes in the brain, or indirectly, by contributing to dehydration and poor sleep, both of which are known migraine triggers. The study emphasises the importance of recognising and avoiding these triggers in migraine management.

Beyond migraines, heatwaves have adverse affects on those who live with MS, too. For the unversed, multiple sclerosis (MS) is a chronic neurological condition where the immune system mistakenly attacks the protective covering of nerve fibres in the central nervous system, explains Rajit Pillai, Specialist Neurology, Aster Clinic, King Faisal Road (Sharjah).

And heat sensitivity just compounds the difficulties. “MS damages the myelin sheath around nerves. Heat further slows the already impaired nerve signal conduction, worsening symptoms like weakness, fatigue, vision problems, and cognitive issues,” says Dr. Kawale. Even small increases in body temperature, about 0.5 to 1°C (1 to 2°F), can provoke noticeable symptom flare-ups. Fortunately, these heat-induced exacerbations are usually temporary and improve once the body cools.

Heat can influence epilepsy both directly and indirectly. There’s a rare form called ‘Hot water epilepsy,’ where heat is a specific trigger, but more commonly, heat affects epilepsy by causing dehydration and electrolyte imbalances that lower the seizure threshold. “Extreme heat can lead to hyperthermia or heatstroke, which may directly provoke seizures due to brain stress or injury,” Dr. Kawale explains. Heat can also affect how anti-seizure medications are metabolised, especially if dehydration impairs kidney or liver function. Additionally, sleep disruption and stress, common during heatwaves, are known seizure triggers.

For migraines, Dr. Kawale cautions that some symptoms signal urgent attention:

·         Sudden severe migraine with neurological signs like vision loss, weakness, or speech difficulty.

·         Migraines unresponsive to usual treatments

·         New or prolonged symptoms lasting longer than an hour (which can mimic stroke)

·         Severe light or sound sensitivity paired with nausea or vomiting, especially in hot environments

Dr. Firouzjaei adds from a Chinese medicine viewpoint that rising internal heat manifests early through symptoms such as extreme thirst, no urination, dizziness, severe dryness of skin, mouth, lips, nose, and eyes, and exhaustion. “Before dangerous symptoms like disorientation or fainting set in, these are alarming signs indicating the need for immediate rehydration.”

Stay hydrated – but smartly:

Use cooling tools:

Create a migraine-friendly environment:

·         Use blackout curtains, UV window films, or wear polarized sunglasses.

·         Avoid fluorescent lighting or flickering screens, blue-light-blocking glasses can help.

For individuals living with epilepsy or multiple sclerosis (MS), it’s important to consult a healthcare professional, as each case is unique and may require personalized medical advice.