Demyelinating Disorder with Optic Neuropathies in a Patient with Monoclonal Gammopathy

Neurologic involvement in monoclonal gammopathy typically consists of demyelinating/axonal peripheral neuropathies with many features in common with chronic inflammatory polyneuritis. Evidence of CNS involvement is occasionally present. Clinical findings reported include nystagmus, ataxia, dysarthria, and extensor plantar responses. MRI scans typically show multiple white matter lesions, similar findings are reported in Chronic Inflammatory Demyelinating Polyneuropathy (CIPD), and similar to MS (1). CSF findings are generally acellular with occasionally elevated protein, oligoclonal bands are typically absent (2).