skip to main content

MS – Intrathecal Baclofen for Severe Spasticity — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardMultiple Sclerosis & CNS InflammationMS – Intrathecal Baclofen for Severe SpasticitySCE Neurology

A person with advanced multiple sclerosis has painful generalised spasticity despite trigger treatment, physiotherapy, goal-directed titration of oral baclofen and a subsequent gabapentin trial. Sedation now prevents further oral escalation. What is the best next service-level decision?

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

Reveal the answer and explanation

Correct answer: A — Assess for intrathecal baclofen in a tertiary spasticity service

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

A adds high-risk sedation without specialist reassessment. B incorrectly turns a patient-specific trade-off into an absolute rule. C is correct: after reversible aggravators, physical management and oral baclofen or gabapentin fail to meet agreed goals, NICE directs referral to a specialist multidisciplinary spasticity service; intrathecal baclofen requires careful goal, trial and pump-risk assessment. D bypasses that process. E offers irreversible surgery prematurely.

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