Total Protein Content of Cerebrospinal Fluid in Multiple Myeloma

The relation between chronic polyneuropathy and osteosclerotic myeloma.

“…The original pubic bone biopsy (Fig. 12) (Madonick and Solomon, 1953). These criteria are generally consistent with those of the Landry-Guillain-Barre syndrome (Wiederholt, Mulder, and Lambert, 1964).…”

“…These numbers do not include certain other reports (Kurnick and Yolahem, 1948, cases 1 and 3; Madonick and Solomon, 1953;Victor, Banker, and Adams, 1958, case 5; Williams, Diamond, Craver, and Parsons, 1959, case J. G.; Barron, Rowland, and Zimmerman, 1960;and Bibliography-1'2), some of which do not describe the cases; in some the clinical picture was complicated by myelomatous compression or infiltration, or amyloid deposition, and in some the neuropathy was not a chronic symmetrical polyradiculoneuropathy. In two recent descriptions the writers comment on the unusual osteosclerotic myeloma in their cases (Small, Moxon, and Woolf, 1961;Aguayo, Thompson, and Humphrey, 1964), and ask whether this is more than a chance association.…”

Clinical Features of Multiple Myeloma

“…Cerebro-spinal Fluid (CSF) Changes in CSF have been reported in myeloma. 7,9,12,16,19 In our series lumbar puncture was performed in only 6 patients-5 because of neurological signs, i because of epilepsy. In the latter, the CSF was normal, but in 4 of the 5 patients with neurological involvement-all of whom had collapsed lumbar vertebrae-the protein was raised (see Table 2).…”

The Neuropathy of Multiple Myeloma

“…There was no obstruction to the flow of cerebrospinal fluid to explain this abnormality. Nor could the neuropathy itself be accepted as an adequate explanation, since an elevated spinal fluid protein level has been described in patients with multiple myeloma and without neurological complications (Degenhardt and Sheehan, 1949;Madonick and Solomon, 1953).…”

“…Here the occurrence of neuropathy is merely mentioned, with little or no description of the neurological signs. Falling into this category are Case 3 of White and Tillinghast (1950) and Cases 6, 8, 10, and 14 of Madonick and Solomon (1953). Snapper et al (1953) recognize a form of a peripheral neuritis in multiple myeloma in which no direct involvement of nerves or nerve roots could be demonstrated.…”