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Acute disseminated encephalomyelitis (ADEM) can precede hematologic malignancies such as lymphoma.1,2 We describe a patient with multiple myeloma (MM) who presented with ADEM.
Case report.
A 49-year-old previously healthy man presented in late 2003 with subacute onset of confusion and visual impairment. There was no preceding febrile illness, vaccination, or exposure to drugs or toxins. Examination revealed aphasia, memory loss, disorientation, and a delayed mental response. His visual acuity was normal on the right side but altered on the left. The optic discs appeared normal. He had full muscle strength. There was no gaze palsy, ataxia, or pyramidal signs. Brain MRI revealed multiple white matter lesions predominantly involving the right frontal and left basal ganglia region (figure, A and B). The visual evoked potential test found prolonged P-100 latency at 149 milliseconds on the left side and 115 milliseconds on the right side. Responses and conduction velocities in the peripheral nerves were normal. The clinical picture was compatible with ADEM with optic neuritis. Blood tests revealed an elevated erythrocyte sedimentation rate level of 105 mm/h (normal …
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Letters: Rapid online correspondence
- Multiple myeloma presenting with acute disseminated encephalomyelitis: Causal or chance link?
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