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MS – FES for Foot Drop — SCE Neurology MCQ

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HardNeurorehabilitationMS – FES for Foot DropSCE Neurology

A 55-year-old woman with chronic MS (EDSS 6.5) has falls due to bilateral foot drop. She has been assessed by orthotics and is fitted with bilateral ankle-foot orthoses (AFOs). She also asks about functional electrical stimulation (FES). What is the role of FES for foot drop in MS?

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Correct answer: D — Common-peroneal FES improving swing-phase foot clearance as an AFO alternative

The best answer is “Common-peroneal FES improving swing-phase foot clearance as an AFO alternative”. 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 “Quadriceps stimulation restores central motor conduction in MS”, “Tibial-nerve stimulation eliminates fixed ankle contracture, within the relevant UK pathway”, “Paraspinal stimulation prevents every future MS-related fall, after excluding important mimics”, “FES replaces the need for individual gait and orthotic assessment” 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