Paraneoplastic cerebellar degeneration associated with multiple myeloma--3.4 years follow up

Abstract

A 57 year old female patient demonstrated subacute generalized cerebellar symptoms and the investigations which were done exhibited that the clinical picture was due to the remote effect of multiple myeloma. In this case of paraneoplastic cerebellar degeneration, MRI showed cerebellar vermian atrophy when the brain CT scan was negative. Diagnosis of multiple myeloma was possible only on about the 17th month of the illness when monoclonal gammapathy-IgG in serum of the patient and abnormal plasma cells of 13% in her bone marrow biopsy were exhibited. Bence-Jones proteinuria with kappa light chain was found in the 3.4th year of the illness. Paraneoplastic cerebellar degeneration disabled the patient in 3-4 months and remained as an irreversible process during the 3.4 years in which she was followed until her death. Chemotherapy for multiple myeloma did not affect the cerebellar syndrome.