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Visual Neglect – Rehabilitation — SCE Neurology MCQ

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HardNeurorehabilitationVisual Neglect – RehabilitationSCE Neurology

A 49-year-old with established secondary progressive MS has accumulated disability for 18 months without relapses. Two recent MRIs show no new or enhancing lesions. Which statement best reflects NICE commissioning of siponimod?

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Correct answer: B — Inactive SPMS; this presentation falls outside the current NICE siponimod population

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

C is correct. NICE recommends siponimod for SPMS only with active disease, defined by relapses or imaging features of inflammatory activity. Disability progression confirms SPMS trajectory but does not by itself meet this activity definition. A conflates progression with inflammation. B is the wrong disease phenotype. D invents a surrogate. E invents an age exception.

Reference: NICE TA656 — siponimod for secondary progressive MS: https://www.nice.org.uk/guidance/ta656/chapter/1-Recommendations