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APS-Associated Chorea — SCE Neurology MCQ

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HardMovement DisordersAPS-Associated ChoreaSCE Neurology

A patient receiving botulinum toxin type A for chronic migraine has 17 headache days per month after two full treatment cycles, down from 22. Medication overuse is appropriately managed. What does NICE TA260 advise?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Stop treatment because the reduction is about 23%, below the required 30%

Explanation lettering: E = shown as A · A = shown as B · D = shown as C · C = shown as D · B = shown as E

A is correct: the reduction is 5/22, about 23%, so it fails the 30% response threshold after two cycles. B mistakes persistent eligibility for efficacy. C invents a four-cycle assessment. D confuses the separate positive stopping rule, which requires conversion to fewer than 15 headache days for three consecutive months. E is not a therapeutic migraine regimen. The decision requires the exact denominator and the correct TA-specific time point.

Reference: NICE TA260: botulinum toxin type A for chronic migraine: https://www.nice.org.uk/guidance/ta260/chapter/1-Recommendations