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Relapsing-remitting multiple sclerosis — SCE Neurology MCQ

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HardMSRelapsing-remitting multiple sclerosisSCE Neurology

A person with established multiple sclerosis develops a disabling new internuclear ophthalmoplegia and gait ataxia. Urinalysis and clinical assessment show no infection. Symptoms began 6 days ago and admission is not required. Which relapse regimen is recommended by NICE?

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

Reveal the answer and explanation

Correct answer: B — Oral methylprednisolone 0.5 g daily for 5 days

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

A uses low-dose prednisolone rather than the recommended high-dose methylprednisolone regimen. B is correct: NICE recommends oral methylprednisolone 0.5 g daily for 5 days for a relapse needing treatment. C is subtherapeutic. D is not the recommended regimen. E reserves apheresis for selected severe steroid-refractory inflammatory attacks rather than routine first-line MS relapse treatment.

Reference: NICE NG220: multiple sclerosis in adults: https://www.nice.org.uk/guidance/ng220/chapter/Recommendations