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Neurology Now:
doi: 10.1097/01.NNN.0000451322.98162.7c
Departments: The Waiting Room

Quick Tips: Summer Safety

Collier, Andrea King

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For people living with neurologic conditions such as epilepsy, multiple sclerosis, migraines, or pinched nerves, summer can present challenges.

Here are some tips that can help make your season healthy and safe.

KEEP YOUR COOL: Anthony Reder, M.D., a member of the American Academy of Neurology (AAN) and professor of neurology at University of Chicago Medicine who specializes in multiple sclerosis (MS), notes that people living with MS can be very sensitive to heat. “Heat can interfere with memory, thinking speed, balance, strength, and energy levels in people with MS,” Dr. Reder says. He advises his patients to conserve energy when the weather is hot. “Exercise in the morning when it's still cooler outside,” he says.


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FIND SOME SHADE: A 2009 study in the American Academy of Neurology's journal Neurology of 7,000 patients found that exposure to higher temperatures—and, to a lesser degree, lower barometric pressure—increased the risk of going to the emergency department for headache. In a Chinese study published in the Journal of European Neurology in 2013, sunlight was found to be the third most common trigger in both migraine and tension-headache patients. The fourth most common trigger in migraine patients was change of the weather.

“Patients who find that their headaches increase in warmer weather should avoid prolonged exposure outdoors,” says Orly Avitzur, M.D., Fellow of the AAN (F.A.A.N.), Neurology Now Editorial Advisory Board member, and practicing neurologist. Dr. Avitzur also suggests that people with headaches who are sensitive to sunlight should make sure they wear sunglasses that offer UV protection.

DRINK UP: One of the symptoms of MS is frequent urination. To prevent it, people with MS often reduce their water intake. However, this can be dangerous—especially in the summer months. According to Dr. Reder, people with MS should drink adequate water but also be aware that caffeinated beverages, as well as some medications used for other conditions (such as diuretics for controlling blood pressure), can impact how the body absorbs water.

Dehydration can also pose special risks for people taking antiepileptic drugs (AEDs), according to Orrin Devinsky, M.D., F.A.A.N., and director of the New York University and Saint Barnabas Epilepsy Centers at the New York University School of Medicine. “Make sure that all AEDs are taken as prescribed. Topiramate (brand name Topamax), zonisamide (Zonegran), and acetazolamide (Diamox) each increase a person's risk of kidney stones. And the risk of kidney stones is also increased with dehydration,” Dr. Devinsky says.

GET MOVING…SAFELY: “Many summer sports can aggravate conditions such as pinched nerves in the neck or back,” Dr. Avitzur says. “If you start to feel pain, stop the activity. Consider low-impact sports such as swimming.”

For people with epilepsy, extra precautions should be taken when swimming. “People with epilepsy should not swim alone. If their seizures are not well-controlled, they should be closely supervised in pools,” Dr. Devinsky says.

Of course, the best way to stay safe during the summer is to talk to your neurologist—in the spring.

© 2014 American Academy of Neurology

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