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SISCOM — SCE Neurology MCQ

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HardClinical NeurophysiologySISCOMSCE Neurology

A child with focal seizures has a unilateral focal cortical dysplasia on MRI but has tried only one appropriately chosen antiseizure medicine. Seizures persist and development is slowing. What is the best referral decision?

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Correct answer: E — Early tertiary referral for lesion-directed epilepsy-surgery assessment

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

B is correct. NICE permits early tertiary referral when MRI shows lesions carrying high drug-resistance risk, including malformations of cortical development, and developmental deterioration adds urgency. A fixed number beyond drug resistance is not required. Learning disability must not exclude referral, VNS is not a substitute for resective assessment, and delayed routine EEG does not address the opportunity for seizure control.

Reference: NICE NG217 non-pharmacological epilepsy treatment: https://www.nice.org.uk/guidance/ng217/chapter/non-pharmacological-treatments