Paraneoplastic acute disseminated encephalomyelitis associated with multiple myeloma
Lai Yin Law1, Kanae Jennifer Nagao1
1Sunshine Hospital, Western Health, Victoria, Australia.
Abstract:
We describe a man recently diagnosed with multiple myeloma who presented with progressive spastic paraparesis, encephalopathy and multifocal MRI lesions with haemorrhage. Brain histopathology was consistent with acute disseminated encephalomyelitis (ADEM) with no new clinicoradiological findings on follow-up. This case emphasises the growing paraneoplastic spectrum, including non-classical but treatable disorders such as ADEM.
Insights
Multiple myeloma can present with neurological issues like acute disseminated encephalomyelitis (ADEM). This treatable condition highlights the expanding paraneoplastic spectrum in cancer patients.
Area of Science:
- Neurology
- Oncology
- Pathology
Background:
- Multiple myeloma is a plasma cell malignancy.
- Paraneoplastic syndromes involve cancer-related neurological disorders.
- Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease.
Observation:
- A patient with newly diagnosed multiple myeloma developed progressive spastic paraparesis and encephalopathy.
- MRI revealed multifocal brain lesions with hemorrhage.
- Brain biopsy confirmed ADEM.
Findings:
- The histopathology was consistent with ADEM.
- No new clinicoradiological findings emerged during follow-up.
- The neurological presentation was linked to the underlying multiple myeloma.
Implications:
- This case expands the known paraneoplastic spectrum associated with multiple myeloma.
- ADEM, though non-classical, should be considered in myeloma patients with neurological symptoms.
- Early diagnosis and treatment of paraneoplastic ADEM can improve patient outcomes.
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