Neurological manifestaions among Sudanese patients with multiple myeloma

Background: Multiple myeloma may involve the nervous system at every level, including the neuromuscular junction, peripheral nerve, plexus, spinal nerve root, spinal cord, meninges, and brain. Such involvement may be primary or secondary, as well as non-invasive paraneoplastic effects.Objective: To find out the perevalence and pattern of CNS manifestations in Sudanese patients with multiple myeloma seen in Al-Shaab Teaching Hospital and Khartoum Nuclear Hospital.Methodology: This is a prospective descriptive cross sectional, hospital based study. It was conducted in Al-Shaab Teaching Hospital and Khartoum Nuclear Hospital in the period from June2009 to June 2010. 50 patients with multiple myeloma were included in the study.Results: Males were more than females with ratio of 2.8:1. The common (36%) age of presentation was between 55-64 years. There was increased incidence of multiple myeloma in patients from the west of Sudan. Farmers and free workers had high incidence of multiple myeloma (34% and 27%respectively). The study demonstrated that the most common non-  neurological symptoms was locomotor symptoms (24%) ,while the most common neurological symptoms were backache and neck pain .The most common neurological findings were cord compression (8%) followed by peripheral neuropathy (2%) and CVA (2%). 22% of patients completed treatment with good response, 12% with partial response, 18% with no response and 48% are still on treatment.Conclusion: CNS involvement among our studied group was not  uncommon.Keywords: neuromuscular, paraneoplastic, monoclonal immunoglobulin