The relation between chronic polyneuropathy and osteosclerotic myeloma.

Recently attention has been directed to the various non-metastatic neurological manifestations of malignant diseases, and myeloma, noted for its presentation by signs of compression and infiltration, is less widely known in association with chronic symmetrical polyradiculoneuropathy. This paper discusses certain clinical aspects of this neuropathy. We have found 16 accounts of the association with multiple myeloma (Table I), and seven with 'single' myeloma (Table II). 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. By reporting four more cases and reviewing the literature, we conclude that this concurrence is significant. In addition, our observations indicate that if the myeloma can be controlled, this otherwise fatal neuropathy is reversible.