Weather and Vestibular Migraine
Barometric pressure, dizziness, heat, humidity and storms
Interview by Weathera · Published
The Vestibular Disorders Association (VeDA) works to inform, support and advocate for people living with vestibular disorders. For individuals navigating dizziness, vertigo and balance difficulties, its educational materials and support resources can help make complex conditions easier to understand. Readers seeking further background can explore VeDA’s guide to vestibular migraine.
To explore how weather may relate to vestibular migraine, Weathera asked Shin Beh, MD, FAAN, FAHS, founder and director of the Beh Center for Vestibular & Migraine Disorders, to share his clinical perspective. The center specializes in caring for people with migraine, dizziness, vertigo and balance disorders, with a particular focus on the relationship between migraine and vestibular symptoms.
People with vestibular migraine sometimes notice that their symptoms change before storms or during periods of heat, humidity or shifting atmospheric pressure. Understanding these experiences can be challenging: weather systems bring several environmental changes at once, and vestibular migraine attacks may occur without a significant headache.
In the following five-question interview, Dr. Beh discusses commonly reported weather triggers, possible explanations for pressure sensitivity, dizziness without headache, the distinction between triggers and early symptoms, and the potential value of tracking symptoms alongside local weather. His answers highlight both the usefulness of recognizing individual patterns and the uncertainty involved in attributing symptoms to a single weather factor.
We thank the Vestibular Disorders Association for its work supporting and educating the vestibular community, and Dr. Beh for taking the time to share his expertise with Weathera’s readers. We encourage readers to explore the resources available through VeDA and the Beh Center for further information about vestibular disorders and migraine.
Key takeaways
- Dr. Beh's answers highlight an important distinction: noticing a relationship with the weather does not necessarily mean that one individual weather variable is responsible.
- A storm can bring simultaneous changes in barometric pressure, temperature, humidity, wind and other environmental conditions. This makes it difficult to isolate a single factor.
- For people with vestibular migraine, another complication is that an attack does not necessarily involve a significant headache. Dizziness, vertigo or imbalance may be prominent symptoms, and dizziness itself may sometimes occur during the prodromal phase of migraine.
- Tracking symptoms alongside weather conditions may therefore be useful for identifying personal patterns over time, rather than assuming that every change in pressure or every storm will cause symptoms.
- If a consistent pattern emerges, treatment decisions — including when and how to use rescue medication — should follow the individualized plan discussed with the patient's healthcare professional.
Editorial summary by Weathera, based on Dr. Beh’s answers.
Which weather conditions do people with vestibular migraine commonly report as problematic?
For people with vestibular migraine who notice that their symptoms change with the weather, which weather conditions do they most commonly report as problematic — for example changes in barometric pressure, storms, heat, humidity, or rapid temperature shifts?
Weather is a very commonly reported migraine trigger but because weather changes are so complex, it has been difficult to pin down exactly what changes in the weather are responsible. Many patients report that their symptoms flare up just before storms. Some report flare ups with heat and humidity. It can be difficult to ascertain if barometric pressure, temperature, or humidity changes are to blame since all these factors change with the weather. It could also be a combination of all these changes.
Can changes in barometric pressure contribute to vestibular migraine symptoms?
Barometric pressure changes are often mentioned by people with vestibular migraine. What mechanisms might explain why changes in atmospheric pressure could contribute to dizziness, vertigo, or other vestibular migraine symptoms in some individuals? Why might one person be very sensitive while another notices little or no effect?
Again, it's very hard to say for sure if barometric pressure changes are the sole trigger for weather-related migraine attacks because changes in temperature and humidity also occur. Some have suggested that a drop in barometric pressure just before a storm causes pressure changes in the sinus cavities which irritate the trigeminal nerve. Other hypotheses point towards temperature swings, wind systems, humidity, and air pollutants.
Can vestibular migraine cause dizziness or vertigo without headache?
Can weather-related vestibular migraine present mainly as dizziness, vertigo, imbalance, or motion sensitivity without a significant headache? If so, could this make it harder for people to recognize that their symptoms are migraine-related?
So, vestibular migraine can often manifest without headache, regardless if the attacks are weather-triggered or not. In some, there can be some difficulty identifying the onset of an attack.
Is dizziness before a storm a trigger response or migraine prodrome?
Some people report dizziness or other symptoms before a storm or an obvious weather change. Could these symptoms sometimes be part of the migraine prodrome rather than a direct response to the weather itself? How should patients think about the difference between a trigger and an early symptom of an attack?
Prodromes are the early phase of a migraine attack. Dizziness can be a prodrome in some, but that's not specific to weather changes. Any migraine trigger can initiate prodromal symptoms.
Can tracking weather and vestibular migraine symptoms help identify patterns?
For someone who repeatedly notices vestibular migraine symptoms around particular weather changes, how would you recommend using symptom tracking and weather forecasts in a useful way? Are there practical steps patients can take when a potentially difficult weather change is approaching?
They can use apps that track migraine attacks and weather changes to see if they can find a potential link. If there is a relationship between weather changes and migraine attacks, I recommend using their rescue medication(s) as early as possible, perhaps even when a weather front is approaching to preempt the attacks.
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Open Weathera forecastAbout Dr. Shin Beh
Shin Beh, MD, FAAN, FAHS is a neurologist specializing in vestibular migraine and neuro-vestibular disorders and is the founder of the Beh Center for Vestibular & Migraine Disorders.