Myeloma Neuropathy

Two patients with occult solitary myeloma had a progressive, painful sensorimotor peripheral neuropathy that improved after localized radiotherapy to the myeloma site. The patients have had remissions of the neuropathy and myeloma for 10 and 11/2 years. Review of 46 cases of myeloma and neuropathy indicates that a progressive, painful sensorimotor neuropathy in a middle-aged man suggests a myeloma neuropathy. The neuropathy preceded detection of the myeloma in 80% of the cases. The myeloma was solitary 24% of the time. Radiotherapy, particularly to a solitary myeloma, offered the greatest chance for remission of the neuropathy.