Impact of delayed diagnosis and treatment in clinically isolated syndrome and multiple sclerosis.

Multiple sclerosis (MS) is a progressive inflammatory disease with several possible clinical courses; before the development of definite MS, some patients may have clinically isolated syndrome (CIS), which is a single attack of neurological symptoms caused by inflammation or demyelination. Disease-modifying treatments (DMTs) have been extensively used for the management of MS, resulting in improvements in the clinical presentation and decreases in MS-associated neurological damage. Earlier initiation of DMT in the course of MS is associated with better outcomes. For patients with CIS, initiation of interferon-beta or glatiramer acetate treatment after an initial clinical event indicative of MS has been associated with delays in the progression to clinically definite MS as well as improvements in measures of neurological damage via magnetic resonance imaging. The initiation of treatment for patients with CIS should be considered, and nurses play a vital role in educating patients about the risks of conversion to MS and the benefits of early DMT.

The pathophysiology of demyelination and the ionic basis of nerve conduction in multiple sclerosis: an overview.

Multiple sclerosis (MS) affects young adults during the prime of life, complicating child-rearing and work-related activities, often resulting in significant disability. New treatment options are rapidly becoming available. Persons with MS and their families rely on nurses to provide current and accurate information. Neuroscience nurses are increasingly challenged to keep abreast of new treatments and research and the scientific bases for them. In response to this need, nurses must develop a basic understanding of the proposed etiology of MS as well as of the pathophysiology of demyelination and the ionic basis of nerve conduction.

Helping a family cope with a terminally ill baby.

This account can give only a brief glimpse of my experience working with a family with a terminally ill baby at home. Functioning in the extended role of health visitor, I became the family's key worker, avoiding the need for numerous visiting professionals. I have tried to capture the relationship that developed between this family and myself, which left me feeling personally and professionally enriched.

Nursing interventions for persons receiving immunosuppressive therapies for demyelinating pathology.

The client receiving immunosuppressive therapy for demyelinating disorders faces many challenges. The nurse should be involved in the constant assessment of the client for potential complications of the therapy as well as changes in the underlying disease process. Many of the nursing interventions focus on comfort and symptom management as well as providing information for the client and family to use in understanding the therapy and minimizing the effects of immunosuppression. Involving the family in client management will only strengthen the overall plan and outcomes for client care.

Central pontine myelinolysis: a case study.

Central pontine myelinolysis is a disorder affecting the myelin in the central pontine region of the brain. The disorder usually has a rapid onset which can result in death, even with the appropriate interventions. This paper presents the case of a seventy-one year old patient who developed central pontine myelinolysis and survived. The nursing challenges will be discussed as encountered in a primary nursing setting using a multidisciplinary approach.