Appleby Brian S, Yobs Deborah R
Departments of Pathology, Neurology, and Psychiatry and National Prion Disease Pathology Surveillance Center, Case Western Reserve University, Cleveland, OH, United States.
CJD Foundation, Akron, OH, United States.
Handb Clin Neurol. 2018;153:399-408. doi: 10.1016/B978-0-444-63945-5.00021-0.
Prion diseases (e.g., Creutzfeldt-Jakob disease) are rapidly progressive neurodegenerative diseases that are invariably fatal. Diagnosing prion disease can be difficult and can lead to frustration. There is no currently available disease-altering treatment for prion diseases and the care and management of affected patients are directed towards symptomatic relief and quality of life. In this chapter, we highlight the many unique challenges of prion disease and how they affect care and management strategies. Symptomatic treatment follows many of the same principles observed in geriatric and/or hospice care, with some important differences due to disease-specific characteristics. We provide an overview of pharmacologic and nonpharmacologic strategies for managing symptoms of prion disease. Education and psychosocial support are also very important in managing patients and families affected by the illness and are discussed in detail. Readers of this chapter will understand the context of caring for a patient with prion disease and will be supplied with practical tools for managing symptoms and educating other healthcare personnel and caregivers. Additional resources for assistance in the care of prion disease patients are also discussed.
朊病毒病(如克雅氏病)是快速进展的神经退行性疾病,无一例外都是致命的。诊断朊病毒病可能很困难,还可能令人沮丧。目前尚无改变疾病进程的治疗方法来治疗朊病毒病,对受影响患者的护理和管理旨在缓解症状并提高生活质量。在本章中,我们将重点介绍朊病毒病的诸多独特挑战,以及它们如何影响护理和管理策略。对症治疗遵循许多在老年护理和/或临终关怀中观察到的相同原则,但由于疾病的特定特征存在一些重要差异。我们概述了管理朊病毒病症状的药物和非药物策略。教育和心理社会支持在管理受该疾病影响的患者及其家庭方面也非常重要,并将进行详细讨论。本章的读者将了解护理朊病毒病患者的背景情况,并将获得管理症状以及对其他医护人员和护理人员进行教育的实用工具。还将讨论用于协助护理朊病毒病患者的其他资源。