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LTG-OCP Interaction — SCE Neurology MCQ

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HardEpilepsy & Seizure DisordersLTG-OCP InteractionSCE Neurology

A patient with antibody-supported classic stiff-person syndrome remains substantially disabled by stimulus-triggered spasms despite optimised diazepam and baclofen. There is no active malignancy or major contraindication to immune therapy. Which next disease-directed treatment has the strongest established role?

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Reveal the answer and explanation

Correct answer: B — A therapeutic trial of intravenous immunoglobulin with objective functional outcome measurement

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

E is correct: GABAergic medicines provide symptomatic relief, while IVIg has the strongest established immunotherapy role in disabling classic SPS and maintenance can be individualised using objective response measures. A treats parkinsonism rather than continuous motor-unit overactivity. B overstates plasma exchange evidence and universality. C uses more toxic immunosuppression before the better-supported option. D may influence symptoms in selected pain disorders but does not modify SPS autoimmunity.

Reference: Stiff-person syndrome: https://pn.bmj.com/content/25/1/6