Meningeal Involvement

Meningeal myelomatosis occurs rarely. Limited reports have recently been reviewed.60 Patients may experience headache, mentation changes, multiple cranial nerve palsies, and speech and gait disturbances.61 IgD and IgA myelomas appear to be overrepresented in these cases. Advanced stage with high tumor-labeling index, and, in particular, plasma cell leukemia (19%) are common causes of central nervous system (CNS) disease. Specific laboratory findings include the presence of myeloma cells62 and paraprotein in the cerebrospinal fluid (CSF).63

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