Fair winds and foul headaches

Cooke et al. have studied chinook weather conditions as a trigger factor for migraine headache.1 Chinooks are warm westerly winds specific to Alberta, Canada. By linking daily diaries and contemporaneous meteorologic reports, the authors demonstrate an increased probability of migraine onset both on pre-chinook days and on high wind velocity chinook days for their entire sample. They also demonstrate that the chinook/migraine association is accounted for by a relatively small proportion of patients. The authors’ novel approach to the study of migraine trigger factors extends well beyond the specific trigger they studied. Because migraine is a chronic neurologic disorder characterized by episodic attacks, it is important to distinguish between risk factors for the disorder and risk factors for individual attacks.2,3 Risk factors for the disorder increased the probability of having the chronic disorder migraine. Examples include positive family history, female gender, epilepsy, depression, and low socioeconomic status.2,4 Risk factors for individual attacks, or trigger factors, increase the probability of a migraine …