Neurology: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Neurology

Sample item

A 5-month-old boy with hypopigmented ash-leaf macules has clusters of brief flexor spasms on waking, with developmental regression. EEG shows chaotic high-voltage activity. Which drug is most appropriate for the underlying cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Vigabatrin

Infantile spasms with hypsarrhythmia in tuberous sclerosis form West syndrome. Vigabatrin is the drug of choice in tuberous sclerosis, and ACTH or oral steroids are used for other causes. Early treatment improves developmental outcome, and the retinal toxicity of vigabatrin requires monitoring.

Option by option

  • A. Vigabatrin (correct)

    Correct. Vigabatrin, a GABA transaminase inhibitor, is most effective in tuberous sclerosis.

  • B. Phenytoin

    Phenytoin is not effective in infantile spasms.

  • C. Carbamazepine

    Carbamazepine can worsen some generalised seizures and is ineffective for spasms.

  • D. Ethosuximide

    Ethosuximide treats absence seizures.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Vigabatrin. Infantile spasms with hypsarrhythmia in tuberous sclerosis form West syndrome.

Why is "Phenytoin" not the answer?

Phenytoin is not effective in infantile spasms.

Why is "Carbamazepine" not the answer?

Carbamazepine can worsen some generalised seizures and is ineffective for spasms.

Why is "Ethosuximide" not the answer?

Ethosuximide treats absence seizures.

What concept does this question test?

It tests Neurology in Pediatrics. Vigabatrin is the drug of choice in tuberous sclerosis, and ACTH or oral steroids are used for other causes. Early treatment improves developmental outcome, and the retinal toxicity of vigabatrin requires monitoring.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neurology?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.