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NEUROLOGY 1987;37:335
© 1987 American Academy of Neurology

Motor neuron disease and paraproteinemia

S. Rudnicki, MD, D. A. Chad, MD, D. A. Drachman, MD, T. W. Smith, MD, U. E. Anwer, MD and N. Levitan, MD

Departments of Neurology (Drs. Rudnicki, Chad, Drachman, and Smith), Pathology (Neuropathology) (Drs. Chad, Smith, and Anwer), and Medicine (Dr. Levitan), the University of Massachusetts Medical Center, Worcester, MA.

We studied two patients with motor neuron disease and paraproteinemia. One had amyotrophic lateral sclerosis (ALS) and IgG lambda monoclonal gammopathy. The second had slowly progressive muscular atrophy and an IgM kappa paraprotein, followed by a biclonal gammopathy when an IgA kappa paraprotein appeared. Treatment with immunosuppressive agents and plasmapheresis lowered the serum concentration of the paraproteins. The ALS syndrome progressed despite therapy. The other patient improved, was stable for several years, but then deteriorated despite continued therapy.

Address correspondence and reprint requests to Dr. Chad, Department of Neurology, University of Massachusetts Medical Center, 55 Lake Avenue, North, Worcester. MA 01605–2397.

Received March 7, 1986. Accepted for publication May 20, 1986.






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