- A 61-year-old man presented with acute dysarthria, weakness, and clumsiness of his left hand. Symptoms lasted 10 minutes and resolved completely. The patient denied having any other associated symptoms. He had a 40-pack-year history of cigarette smoking, controlled hypertension, hypercholesterolemia, migraine headache, aortic stenosis, and coronary artery bypass grafting after a myocardial infarction 16 years previously. His coronary artery disease was stable, and he denied having any prior history of stroke or transient ischemic attack .
- A 49-year-old woman had a 10-month history of lowback pain that had developed insidiously. Two months after the back pain was initially noted, it precipitously worsened, and an evaluation by her local physician included a roentgenogram of the lumbar spine that showed a compression fracture of the L-2 vertebral body. Among the tests done in assessment, a serum IgG κ level was increased at 3,910 mg/dL. A subsequent bone marrow biopsy specimen showed IgG κ multiple myeloma. She was treated with melphalan hydrochloride and prednisone for 4 months (total melphalan dose, 172 mg).