skip to main content

MSCC – Dexamethasone and Urgent Treatment — SCE Neurology MCQ

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

HardNeuro-oncologyMSCC – Dexamethasone and Urgent TreatmentSCE Neurology

A patient with progressive dysphagia, nasal speech and tongue wasting also has brisk jaw jerk and limb fasciculations, without sensory loss. Which diagnosis best unifies upper- and lower-motor-neurone signs?

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

Reveal the answer and explanation

Correct answer: E — Bulbar-onset motor neurone disease, given the imaging pattern

The best answer is “Bulbar-onset motor neurone disease, given the imaging pattern”. Progressive bulbar dysfunction with mixed upper- and lower-motor-neurone signs and preserved sensation is typical of motor neurone disease. “Myasthenia gravis” can be reasonable in another presentation, but it does not account for the defining feature here. “Inclusion body myositis” can be reasonable in another presentation, but it does not account for the defining feature here. “Brainstem stroke” can be reasonable in another presentation, but it does not account for the defining feature here. “Length-dependent polyneuropathy” can be reasonable in another presentation, but it does not account for the defining feature here.

Reference: NICE NG42 motor neurone disease recommendations: https://www.nice.org.uk/guidance/ng42/chapter/Recommendations