Median morning body temperature during the luteal phase was compared with that of the follicular and menstrual phases we expected higher temperatures following ovulation. We divided the menstrual cycle into the following 3 phases: menstrual (day 1 to day 4) follicular (days 5-13) and luteal (day 14 to day 28). After data collection for 2 cycles, we treated each patient with oral ASA (650 mg twice daily) and collected data for at least 2 more cycles. Neurologic examinations were performed in the late morning. Fatigue was rated using a 100-mm visual analog scale. We instructed each patient to record her morning oral body temperature before rising from bed, the onset and duration of her menstrual period, and type, severity, and change in fatigue and neurologic symptoms. The events lasted 3 to 5 days and resolved at or just prior to the onset of menses. We identified 3 women with relapsing-remitting MS who reported predictable, unvarying, self-limited premenstrual symptoms that included 1 or more focal neurologic symptoms or signs and diurnal fatigue. However, the observed relationship between the luteal menstrual phase and MS symptom worsening is not fully explained by thermoregulation, which implicates other hormonal or immunologic mechanisms. Aspirin (650 mg twice daily) prevented symptoms but did not significantly alter the luteal phase body temperature.Ĭonclusions Aspirin prophylaxis may prevent luteal phase–associated MS pseudoexacerbations. Results Morning oral body temperature did not differ during symptomatic vs asymptomatic portions of the luteal phase ( P = .55). Main Outcome Measures Body temperature, Modified Fatigue Impact Scale, and evaluation of neurologic symptoms and signs. Interventions Body temperature measurement, symptom diary, and oral aspirin. Patients Three women with relapsing-remitting MS. Aspirin treatment prevented the symptoms.ĭesign and Setting Case series at the Mayo Clinic outpatient MS clinics, Scottsdale, Ariz, and Rochester, Minn. Objective To describe 3 women with MS who experienced stereotypic, temperature-independent neurologic symptoms and diurnal fatigue in the mid-to-late luteal phase of the menstrual cycle. Aspirin reduces MS fatigue in some patients. Shared Decision Making and Communicationīackground Many women with multiple sclerosis (MS) experience transient neurologic symptom worsening and fatigue in conjunction with the menstrual cycle.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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