Neurologic Complications of Plasma Cell Dyscrasias

Plasma cell dyscrasias are an uncommon but important cause of neurologic morbidity. The pathophysiology of these disorders is quite varied and ranges from direct effects of cancer on neurologic tissues to remote effects caused by monoclonal antibodies. This chapter discusses these hematologic disorders and their neurologic consequences including monoclonal gammopathy of undetermined significance, multiple myeloma and its rare variants, osteosclerotic myeloma and POEMS syndrome, and primary systemic amyloidosis. While not all of these disorders are classified as malignancies, they all share derivation from a single clone of plasma cells and thus are best discussed as a group. This review gives the clinician a framework for evaluating and treating these patients.