Neurologic complications of myeloma

Patients with multiple myeloma (MM) frequently develop neurological complications related to the disease or its treatment [ 1 – 3 ]. These neurological complications may affect the central nervous system (CNS) [ 4 ] or more commonly the peripheral nervous system (PNS) [ 1, 5 ]. Neurological complications can result from: (a) Direct infi ltration of the nervous system by neoplastic cells [ 4 ] (b) Indirect effect such as paraneoplastic syndrome or amyloid deposition [ 5 ] (c) Iatrogenic effect during multiple myeloma treatment [ 1 ] (d) Toxic-metabolic syndrome related to systemic complications of multiple myeloma [ 6 ] (e) A combination of the above Furthermore, a neurological syndrome can be the presenting sign of multiple myeloma [ 7 ]. In this chapter we will discuss these different neurological complications of myeloma by system (CNS vs. PNS) and the management of these complications (Table 20.1).