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MS Fatigue – Tools — SCE Neurology MCQ

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HardMultiple Sclerosis & CNS InflammationMS Fatigue – ToolsSCE Neurology

A patient with MS reports disabling fatigue. He snores, takes sedating baclofen, has nocturia and a low mood; EDSS is 4.5. Which initial plan is most appropriate?

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

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Correct answer: C — Treat contributors, then tailored self-management and supervised exercise

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

E is correct. NICE says not to assume fatigue is due to MS: sleep, medicines, bladder symptoms, infection, anaemia, thyroid disease, anxiety and depression are considered. Self-management and aerobic/resistance exercise are supported; with EDSS at least 4, supervised activity plus cognitive-behavioural techniques may help. B12 and hyperbaric oxygen are not recommended, inactivity worsens deconditioning, and fampridine is not a fatigue treatment.

Reference: NICE NG220 multiple sclerosis recommendations: https://www.nice.org.uk/guidance/ng220/chapter/Recommendations