RESUMO
BACKGROUND: Many women with multiple sclerosis (MS) are postmenopausal, yet the impact of menopause on MS symptoms is unknown. OBJECTIVE: To investigate patient-reported impact of menopause in a large online research platform, PatientsLikeMe (PLM). METHODS: A detailed reproductive history survey was deployed to PLM members, and responses were linked to PLM׳s prospectively collected patient-reported severity score (MS Rating Scale, MSRS). The MSRS has previously shown good correlation with physician-derived EDSS scores. RESULTS: Of the 513 respondents, 55% were postmenopausal; 54% of these reported induced menopause. Median age at natural menopause was 51. Surgical menopause occurred at an earlier age (p<0.001) and was associated with more hormone replacement therapy use (p=0.02) than natural menopause. Postmenopausal status, surgical menopause, and earlier age at menopause were all associated with worse MSRS scores (p≤0.01) in regressions adjusting for age, disease type and duration. CONCLUSION: Postmenopausal patients in this study reported worse MS disease severity. Further, this study highlights a utility for online research platforms, which allow for rapid generation of hypotheses that then require validation in clinical settings.
Assuntos
Esclerose Múltipla/fisiopatologia , Esclerose Múltipla/psicologia , Pós-Menopausa/fisiologia , Adulto , Análise de Variância , Estudos de Coortes , Avaliação da Deficiência , Feminino , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Sistemas On-Line , Índice de Gravidade de Doença , Inquéritos e Questionários , Adulto JovemRESUMO
Bell's palsy is a peripheral facial palsy of unknown etiology. During pregnancy, there is an increased incidence of idiopathic facial paralysis (Bell's palsy). Nevertheless, bilateral facial paralysis in pregnant woman is a rare phenomenon with only a few case reports in medical literature. We report on a patient with bilateral facial paralysis in pregnancy, with a review of the literature and possible etiologic factors. The patient was treated conservatively and the left facial palsy resolved completely, whereas on the right side there was a residual lesion of facial function. The etiology, treatment and prognosis of Bell's palsy in pregnancy remain controversial.
