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Burst-Suppression Pattern on EEG — SCE Neurology MCQ

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HardClinical NeurophysiologyBurst-Suppression Pattern on EEGSCE Neurology

A patient with Parkinson disease has symptomatic orthostatic hypotension after dehydration, anaemia and culprit medicines are corrected. Supine blood pressure is 138/82 mmHg and ECG is normal. Which pharmacological option should be considered first?

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Correct answer: C — Trial midodrine with monitoring for supine hypertension

NICE advises considering midodrine after medication and reversible-cause review, with monitoring for supine hypertension. Fludrocortisone can be considered if midodrine is unsuitable, with attention to cardiac and fluid risks. Domperidone treats nausea, pyridostigmine is not the NICE first choice here, and propranolol can worsen postural symptoms.

Reference: NICE NG71 Parkinson disease in adults: recommendations (Current NICE recommendations, accessed July 2026): https://www.nice.org.uk/guidance/ng71/chapter/Recommendations