Primary Progressive Multiple Sclerosis — SCE Neurology MCQ

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HardMultiple Sclerosis & CNS InflammationPrimary Progressive Multiple SclerosisSCE Neurology

A 50-year-old man with primary progressive MS has a 2-year history of progressive spastic paraparesis. EDSS is 5.0. MRI shows T2 lesions in the cervical cord and periventricular region with one gadolinium-enhancing lesion. Which DMT has evidence for this form of MS?

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Correct answer: A — Ocrelizumab

The best answer is “Ocrelizumab”. MS care requires phenotype confirmation, relapse assessment, symptom management and specialist disease-modifying therapy; ocrelizumab is an NHS option for eligible early inflammatory primary progressive disease. The alternatives “Interferon beta-1b”, “Glatiramer acetate”, “Natalizumab”, “Fingolimod” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: NICE NG220 multiple sclerosis recommendations: https://www.nice.org.uk/guidance/ng220/chapter/Recommendations