In this supplement to JNN, the authors explore recent research and treatment trends in the care of individuals with multiple sclerosis (MS). Costello provides a brief overview of MS-pathophysiology, clinical presentation, and diagnostics-as well as a deeper look at diagnostic options that speed the process of diagnosis. Faster options that pinpoint a more definitive diagnosis allow us to potentially decrease the frequency of relapse, diminish the degree of inflammatory change and damage in the central nervous system, and consequently reduce the progression of patients' disability. Costello underscores the concept that with the always growing treatment arsenal, nurses who care for patients with MS need to fully understand the mechanisms of action for the various treatment options and their specific effects on disease relapse and progression.
Kennedy examines the possible impact on patients when a diagnosis of MS is delayed. She outlines the issues and current research surrounding the diagnosis of clinically isolated syndrome (CIS) versus a diagnosis of clinically definite MS (CDMS). Patients who present with a single episode of 1 or more MS-related signs and symptoms are often treated less aggressively, or not at all, since their clinical presentation doesn't "fit" the classic description of MS as a disorder with symptoms that present across a temporal and spatial continuum. Treating those with CIS with disease-modifying treatments at the onset of symptoms, despite the single episode, may, in fact, delay progression to CDMS and the radiologic changes seen on MRI.
The articles in the supplement offer an exciting window into diagnostic and treatment options now available for individuals with MS. They provide neuroscience nurses with a solid background that will allow any of us to better understand our patients and their needs and to provide better education and support.