Multiple Cranial Nerve Palsies, Without Definitive Brain Lesion. Rare Case of Plasma Cell Myeloma

Abstract

Plasma cell myeloma rarely presents with neurological symptoms, and if this happens then cause is usually plasmacytoma. This is a very rare case to be presented as multiple cranial nerve palsies, unusual presentation of plasma cell myeloma without involvement of organic brain lesion in literature to date. A 70 years old gentleman having ESRD, was received with diplopia, deviation of angle of mouth, on and off chest pain. Investigations ruled out stroke, cardiac event, autoimmune process or any other possible cause of cranial nerve palsies. Diagnosis of multiple myeloma was confirmed by immune electrophoresis which showed monoclonal gammopathy, punched out lytic lesions were found on skeletal scurvy and later confirmation was done by bone marrow biopsy for the presence of plasma cell myeloma. Key words: plasma cell myeloma, cranial nerve palsies