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MS – Oral vs IV Steroids — SCE Neurology MCQ

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ModerateMultiple Sclerosis & CNS InflammationMS – Oral vs IV SteroidsSCE Neurology

A 37-year-old with relapsing-remitting multiple sclerosis develops new optic neuritis causing reduced visual acuity that impairs work. Infection has been excluded and symptoms began five days ago. She can take oral medication and has no need for inpatient monitoring. Which relapse treatment best follows NICE guidance?

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Correct answer: B — Oral methylprednisolone 0.5 g daily for five days

For a functionally significant confirmed MS relapse, NICE recommends oral methylprednisolone 0.5 g daily for five days. Intravenous methylprednisolone 1 g daily for three to five days is reserved for oral treatment failure or intolerance, or when hospital admission or monitoring is needed. Lower oral doses and unsupervised steroid supplies are not recommended.

Reference: NICE NG220, treating acute relapse: https://www.nice.org.uk/guidance/ng220/chapter/Recommendations