Neurological manifestations of monoclonal gammopathies

The spectrum of peripheral neuropathy associated with monoclonal gammapathy is wide: peripheral neuropathy associated with IgM monoclonal gammapathy, in which serum antibody activity has been demonstrated against MAG (myelin-associated-glycoprotein) and SGPG, mainly presents as a chronic demyelinating sensory polyneuropathy, with predominant tremor and ataxia. Polyneuropathy reported in association with multiple myeloma or MGUS (monoclonal gammapathy of undetermined significance) IgG and IgA are more heterogenous: mainly axonal, mixed or sometimes demyelinating as in POEMS syndrome. The treatment of these polyneuropathies is evaluated in trials in progression using corticosteroids, plasma exchanges and IgIV (polyvalent immunoglobulins).