Aratake Yuriko, Takaya Ryosuke, Shindo Katsuro
Department of Neurology, Kurashiki Central Hospital.
Department of Hematology, Kurashiki Central Hospital.
Rinsho Shinkeigaku. 2021 Nov 24;61(11):739-742. doi: 10.5692/clinicalneurol.cn-001612. Epub 2021 Oct 16.
We present the case of a 67-year-old woman with meningeal carcinomatosis who was treated with chemotherapy for refractory multiple myeloma, and was in remission. She was admitted to our hospital because of tonic seizures and disturbance of consciousness. Monoclonal CD 138-positive plasma cells were detected in her cerebrospinal fluid. Cranial MRI showed gadolinium enhancement of diffuse meninges and cranial nerves. We diagnosed the patient with systemic epilepsy due to meningeal carcinomatosis and administered antiepileptic drugs and intrathecal chemotherapy; however, she showed little improvement, and she passed away on hospital day 74 because of disease progression. Multiple myeloma is known to be associated with neurological symptoms such as peripheral neuropathy, myelopathy, and radiculopathy; however, central nervous system involvement in multiple myeloma is uncommon. We should consider central nervous system involvement in multiple myeloma, such as meningeal carcinomatosis, given the importance of early detection and therapeutic intervention.
我们报告一例67岁患有脑膜癌病的女性病例，她曾因难治性多发性骨髓瘤接受化疗，目前处于缓解期。她因强直性癫痫发作和意识障碍入住我院。在她的脑脊液中检测到单克隆CD 138阳性浆细胞。头颅磁共振成像显示弥漫性脑膜和颅神经钆增强。我们诊断该患者为脑膜癌病所致全身性癫痫，并给予抗癫痫药物和鞘内化疗；然而，她几乎没有改善，最终因疾病进展于住院第74天去世。已知多发性骨髓瘤与周围神经病变、脊髓病和神经根病等神经症状有关；然而，多发性骨髓瘤累及中枢神经系统并不常见。鉴于早期检测和治疗干预的重要性，我们应考虑多发性骨髓瘤累及中枢神经系统的情况，如脑膜癌病。
