CRANIAL AND INTRACRANIAL MYELOMAS
Abstract
(From the National Hospital, Queen Square) Involvement of the nervous system is one of the commonest complications of multiple niyelomatosis. The incidence of brain and orbital manifestations is, however, difficult to discover because authors have not given separate figures for the various parts of the nervous system. They are rarer than spinal cord compression due to myeloma and their infrequency is demonstrated by the fact that in a series of 83 cases of this disease (Bayrd and Heck, 1947) none had direct brain or orbital involvement. An impression of their rarity in neurological practice may be gained from Cushing (1932) who found that among 2,000 intracranial tumours, there were only 4 cranial myelomas. In the absence of any previous survey of the subject, this paper reviews the various neurological features that have been observed in cases with cranial and intracranial myelomas and, in addition, orbital myelomas are considered. A classification of clinical syndromes is suggested and 4 illustrative cases are presented. A patient may show evidence of intracranial or orbital encroachment at any stage of the disease. In occasional patients, however, this may be the first manifestation and they are seen initially by those dealing with neurological or