skip to main content

Thrombectomy-eligible stroke — SCE Neurology MCQ

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

HardStrokeThrombectomy-eligible strokeSCE Neurology

A 34-year-old with non-thymomatous AChR-antibody-positive generalised myasthenia remains steroid dependent despite azathioprine. CT shows no thymoma and surgical risk is low. Which disease-modifying intervention should be discussed?

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

Reveal the answer and explanation

Correct answer: C — Offer thymectomy through an experienced myasthenia surgical service

Thymectomy improves outcomes and reduces treatment burden in appropriately selected younger adults with non-thymomatous AChR-positive generalised myasthenia and should be discussed through an experienced service. IVIG and plasma exchange are important rescue or selected maintenance treatments but are not the preferred definitive intervention in this stable surgical candidate. Efgartigimod is not routinely recommended by NICE for this indication, and rituximab is generally prioritised for selected refractory disease rather than used to bypass an indicated thymectomy.

Reference: Association of British Neurologists guideline for myasthenia gravis (Published 2025; current ABN guideline): https://doi.org/10.1136/pn-2025-004655