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Post-Stroke Statin Therapy — SCE Neurology MCQ

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HardCerebrovascular DiseasePost-Stroke Statin TherapySCE Neurology

A 45-year-old has slowly progressive asymmetric wrist and finger-extension weakness, conduction block outside entrapment sites, preserved sensation and high anti-GM1 IgM titres. Which treatment is most appropriate?

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Correct answer: D — Start intravenous immunoglobulin and monitor objective motor response

The pattern is multifocal motor neuropathy. IVIG is the evidence-based induction treatment and response should be documented objectively. Subcutaneous immunoglobulin can maintain selected responders but is not the usual induction route; plasma exchange can be ineffective or worsen weakness, pyridostigmine treats neuromuscular-junction disease, and riluzole does not treat immune conduction block.

Reference: EFNS/PNS guideline on multifocal motor neuropathy: first revision (Published December 2010; revised specialist guideline): https://pubmed.ncbi.nlm.nih.gov/21199100/