ABSTRACT
Myelomic spinal cord damage may be a result of both its compression and vascular disorders (squeezing of an artery, disorders of venous outflow). Diagnosis is based on evaluation of the following signs: normochromic anemia; increase of ESR, total protein and calcium levels; discovery of M-gradient in protein fractions of gamma-zone; multiple regions of destruction in spondylogramme. In doubtful cases magneto-resonance and computer tomography were the most informative. Highly effective was therapy with intensive chemoprogramme including either a range of preparations (alkeran, BGNU, cyclophosphan, adriblastina, prednisolon) or a combination of polychemotherapy with irradiation. The operation was indicated in both insufficiency of conservative therapy and increasing of the symptoms of the damage.
Subject(s)
Multiple Myeloma/complications , Spinal Cord Compression/complications , Adult , Aged , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Multiple Myeloma/diagnosis , Multiple Myeloma/therapy , Spinal Cord Compression/diagnosis , Spinal Cord Compression/therapy , Tomography, X-Ray ComputedABSTRACT
Histopathologic changes in the brain and spinal cord in multiple myeloma are similar to those seen in toxic encephalopathy with circulatory disorders. Irreversible morphologic changes in the brain and spinal cord are more pronounced in the encephalopathic syndrome. The structures affected most are the cerebral cortex, brain pedicles, medulla oblongata, spinal cord and its radicles. Histopathologic changes include acute nerve cell swelling, primary irritation, cytoplasmic fatty infiltration, shrinkage, excessive lipofucsin deposition, demyelination and diminished numbers of nerve fibers, and predominantly dystrophic, rather than hyperplastic, changes in the glia.
Subject(s)
Central Nervous System/pathology , Multiple Myeloma/pathology , Aged , Central Nervous System Diseases/etiology , Central Nervous System Diseases/pathology , Female , Humans , Male , Middle Aged , Multiple Myeloma/complications , Multiple Myeloma/diagnosis , Plasma Cells/pathologyABSTRACT
A comprehensive examination involving the use of electroencephalography (EEG), rheoencephalography of the main vessels of the head (REG) and vessels of the limbs, electromyography with the application of neurohistological investigation was conducted in 120 myeloma patients. Neurological disorders systematized into syndromes of encephalopathy, local spondylalgia, radiculalgia, myelopathy, meningomyelopolyradicular and encephalomyelopolyradiculoneuropathic syndromes were observed in 91.7% of the cases. The leading role in the pathogenesis of neurological disturbances was played by toxico-dyscirculatory disorders secondary to infiltration of vessel walls by plasmatic cells, dysproteinosis, kidney failure, as well as mechanical impact of the deformed vertebral column on the spinal cord, its radices and vessels. Modern medicated correction of neurological disturbances is considered necessary in myeloma.
