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  4. Confusion, cognitive impairment, and spinal cord compression caused by plasmacytoma: a case report

Confusion, cognitive impairment, and spinal cord compression caused by plasmacytoma: a case report

BMC Neurol, 2021 · DOI: https://doi.org/10.1186/s12883-021-02332-3 · Published: June 29, 2021

OncologyAgingNeurology

Simple Explanation

An 80-year-old man went to the ER with walking difficulties, pain, and confusion. He was evaluated for dementia and ultimately diagnosed with possible Alzheimer’s disease and a malignant plasmacytoma causing spinal cord compression. This report highlights the case of an elderly man whose confusion and cognitive impairment, initially attributed to other causes, were ultimately found to be linked to spinal cord compression caused by a rare tumor called plasmacytoma. The case suggests that unusual results in spinal fluid tests, combined with unexplained confusion, should prompt doctors to look for spinal issues affecting fluid circulation.

Study Duration
Not specified
Participants
One 80-year-old man
Evidence Level
Level 4, Case Report

Key Findings

  • 1
    Spinal cord compression by plasmacytoma can lead to abnormal CSF levels of several known pathology markers for Alzheimer’s disease and neuronal damage.
  • 2
    Highly divergent amyloid CSF levels could be indicative of spinal pathologies affecting CSF circulation.
  • 3
    Elderly confusion patients in ER settings require closer assessment by consultants specialized in neurological disorders.

Research Summary

This case report describes an 80-year-old man who presented to the ER with confusion and walking difficulties and was found to have spinal cord compression caused by a plasmacytoma. The patient's CSF analysis showed abnormal amyloid levels, which, combined with other neurological symptoms, prompted further investigation leading to the plasmacytoma diagnosis. The authors conclude that elderly patients presenting with acute confusion should be thoroughly evaluated for neurological symptoms, and unusual CSF protein levels should prompt investigation for pathologies affecting CSF circulation.

Practical Implications

Enhanced Neurological Assessment

Encourages comprehensive neurological evaluations for elderly patients presenting with acute confusion in emergency room settings.

CSF Analysis Awareness

Highlights the importance of considering spinal pathologies affecting CSF circulation when encountering severely abnormal amyloid CSF levels.

Interdisciplinary Consultation

Promotes consultations with specialists (neurologists, geriatricians) for patients with suspected or confirmed dementia to avoid misdiagnosis.

Study Limitations

  • 1
    Single case report limits generalizability.
  • 2
    Biomarker dynamics above compression not determined.
  • 3
    Rarity of plasmacytoma limits comparative data.

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