The spectrum of peripheral neuropathy in myeloma.

The records of 20 patients with typical or sclerotic (sclerotic or mixed sclerotic and lytic) multiple myeloma and peripheral neuropathy who were seen during a 13-year period were analyzed to determine the natural history of the neuropathy. In the 10 patients with typical multiple myeloma, the clinical pattern was heterogeneous. Chemotherapy for multiple myeloma did not affect the neuropathy. The 10 patients who had sclerotic myeloma presented in a relatively homogeneous manner, with a predominantly motor neuropathy. Tumoricidal radiation therapy to localized plasmacytomas resulted in pronounced improvement in the neuropathy of two patients, mild improvement in three, and mild improvement in the endocrine abnormalities of one patient.