American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following is used for managing neuropathic pain in multiple sclerosis?

1. Dalfampridine

2. Baclofen

3. Gabapentin

4. Cyclobenzaprine

The correct answer is: Gabapentin

Gabapentin is commonly used for managing neuropathic pain in patients with multiple sclerosis. This medication is an anticonvulsant that is effective in treating various types of neuropathic pain due to its ability to modulate excitatory neurotransmitter release and inhibit the transmission of pain signals in the nervous system. Research has shown that gabapentin can help to alleviate pain and improve overall quality of life for those experiencing neuropathic pain associated with neurological conditions, including multiple sclerosis. The other medications listed do not primarily target neuropathic pain. Dalfampridine is primarily utilized to improve walking in patients with multiple sclerosis but does not address pain issues directly. Baclofen is a muscle relaxant that is effective for muscle spasticity in multiple sclerosis but is not indicated for neuropathic pain. Cyclobenzaprine, also a muscle relaxant, is useful for muscle spasms but does not have a clinically proven role in the management of neuropathic pain. Therefore, gabapentin stands out as the most appropriate choice for this specific type of pain management in the context of multiple sclerosis.