Certified Neuroscience Registered Nurse (CNRN) Practice Exam

What is a common treatment approach for progressive multifocal leukoencephalopathy?

1. High-dose corticosteroids

2. Immunosuppressive therapy

3. Antiretroviral therapy

4. Supportive care

The correct answer is: Antiretroviral therapy

Progressive multifocal leukoencephalopathy (PML) is a rare and serious neurological condition caused by the reactivation of the JC virus, particularly in individuals who are immunocompromised. The primary focus of treatment for PML revolves around addressing the underlying immunosuppression, particularly in patients with conditions like HIV/AIDS. Antiretroviral therapy is specifically designed to help restore immune function in HIV-infected individuals. By effectively suppressing the replication of the HIV virus, antiretroviral therapy can lead to an improvement in the patient’s immune status, which can result in a reduction of viral load and potentially the reactivation of the JC virus that causes PML. As such, this therapy is a crucial component in the management of PML within the context of HIV-positive patients. Other treatment approaches like high-dose corticosteroids and immunosuppressive therapy do not directly combat the JC virus and could potentially worsen the outcome for patients with PML by further suppressing an already compromised immune system. Supportive care focuses on managing symptoms but does not address the underlying viral infection. Thus, antiretroviral therapy remains the most appropriate and targeted treatment modality in the context of PML associated with HIV.