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Lennox-Gastaut syndrome — SCE Neurology MCQ

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HardEpilepsyLennox-Gastaut syndromeSCE Neurology

A 19-year-old with Lennox–Gastaut syndrome has persistent drop seizures despite appropriate trials of two antiseizure medicines. Cannabidiol is added to clobazam. At the 6-month review, drop-seizure frequency has fallen from 80 to 60 per month. What does NICE recommend?

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

Reveal the answer and explanation

Correct answer: D — Stop cannabidiol at six months because seizure reduction is below 30%

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

A and B misstate the threshold. C incorrectly delays the mandated review. D removes the required combination context. E is correct: the reduction is (80−60)/80 = 25%, so it fails NICE’s minimum 30% improvement at the 6-month check and cannabidiol should be stopped. The item tests both the appraisal’s stopping rule and a simple but clinically consequential calculation.

Reference: NICE TA615: cannabidiol with clobazam for Lennox–Gastaut syndrome: https://www.nice.org.uk/guidance/ta615/chapter/1-Recommendations