Neurological aspects of multiple myeloma and related disorders

Area of Science:

• Neurology
• Hematology
• Oncology

Background:

• Multiple myeloma (MM) and related plasma cell dyscrasias present with a broad spectrum of neurologic complications.
• These complications arise from various mechanisms including direct compression, tumor infiltration, metabolic disturbances, and immune-mediated processes.

Purpose of the Study:

• To comprehensively review the diverse neurologic complications associated with multiple myeloma (MM).
• To discuss neurologic manifestations in related conditions such as monoclonal gammopathy of undetermined significance (MGUS), Waldenström macroglobulinemia (WM), POEMS syndrome, amyloidosis, and cryoglobulinemia.

Main Methods:

• Literature review of neurologic complications in MM and related disorders.
• Categorization of complications by underlying mechanism (compressive, infiltrative, metabolic, autoimmune).

Main Results:

• Compressive radiculopathy is a common presentation in MM.
• Peripheral neuropathies are frequently observed in various related disorders.
• Other complications include spinal cord compression, base-of-the-skull tumors, amyloid infiltration, numb chin syndrome, slowed mentation, and autoimmune neuropathies.

Conclusions:

• Neurologic complications are a significant clinical challenge in MM and associated plasma cell disorders.
• Understanding the diverse mechanisms is crucial for accurate diagnosis and management.
• This review provides a framework for recognizing and addressing these neurologic issues across a spectrum of hematologic malignancies.