[Subclinical neuropathies and paraproteinemias]

Area of Science:

• Neurology
• Clinical Electrophysiology

Context:

• Monoclonal gammopathies, including monoclonal gammopathy of uncertain significance (MGUS) and multiple myeloma (MM), are associated with peripheral nerve involvement.
• Pathogenesis theories include infiltrative, compressive, ischemic, or hemorrhagic phenomena, amyloidosis, and antibody-mediated autoimmune responses against neural antigens.

Purpose:

• To investigate the prevalence of subclinical neuropathy in patients with monoclonal gammopathies using neurophysiological examinations.
• To assess the utility of nerve conduction studies and reflex testing in detecting peripheral nerve abnormalities in this patient cohort.

Summary:

• Neurophysiological examinations were performed on 35 patients with monoclonal gammopathies (MGUS, MM, MG IgM) after excluding 10 patients due to confounding factors.
• Subclinical neuropathy was detected in 11 of 35 patients (30%) who were asymptomatic.
• Carpal tunnel syndrome (CTS) was identified in 4 patients.

Impact:

• Highlights a high rate of subclinical neuropathy in asymptomatic patients with monoclonal gammopathies.
• Suggests the need for further research into the presence of subclinical neuropathy in monoclonal gammopathy of uncertain significance (MGUS) cases.