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Updated: Oct 16, 2025
Minimally Invasive Cisterna Magna Injection Model for Leptomeningeal Metastasis Studies in Mice
Published on: May 23, 2025
[Myelomatous meningitis: a case report]
Yuriko Aratake1, Ryosuke Takaya2, Katsuro Shindo1
1Department of Neurology, Kurashiki Central Hospital.
Abstract:
We present the case of a 67-year-old woman with meningeal carcinomatosis who was treated with chemotherapy for refractory multiple myeloma, and was in remission. She was admitted to our hospital because of tonic seizures and disturbance of consciousness. Monoclonal CD 138-positive plasma cells were detected in her cerebrospinal fluid. Cranial MRI showed gadolinium enhancement of diffuse meninges and cranial nerves. We diagnosed the patient with systemic epilepsy due to meningeal carcinomatosis and administered antiepileptic drugs and intrathecal chemotherapy; however, she showed little improvement, and she passed away on hospital day 74 because of disease progression. Multiple myeloma is known to be associated with neurological symptoms such as peripheral neuropathy, myelopathy, and radiculopathy; however, central nervous system involvement in multiple myeloma is uncommon. We should consider central nervous system involvement in multiple myeloma, such as meningeal carcinomatosis, given the importance of early detection and therapeutic intervention.
Insights
This case study highlights meningeal carcinomatosis in a multiple myeloma patient presenting with seizures. Early detection of central nervous system involvement is crucial for timely intervention.
Area of Science:
- Neurology
- Oncology
Background:
- Multiple myeloma can present with neurological complications, though central nervous system (CNS) involvement is rare.
- This case involves a 67-year-old woman with refractory multiple myeloma in remission.
Observation:
- The patient experienced tonic seizures and altered consciousness.
- Cerebrospinal fluid analysis revealed monoclonal CD 138-positive plasma cells.
- Cranial MRI demonstrated diffuse meningeal and cranial nerve enhancement.
Findings:
- Diagnosis of systemic epilepsy secondary to meningeal carcinomatosis was made.
- Treatment with antiepileptic drugs and intrathecal chemotherapy yielded minimal improvement.
- The patient succumbed to disease progression.
Implications:
- Meningeal carcinomatosis should be considered in multiple myeloma patients with neurological symptoms.
- Early diagnosis and prompt therapeutic intervention are vital for managing CNS involvement in multiple myeloma.
- This case underscores the importance of recognizing uncommon neurological manifestations of multiple myeloma.
