Quiz Form

Question Date: 11/01/2024

Question: Which of the following neurological manifestation is less likely to occur with POEMS syndrome?

Options:

• Papilledema
• Acute Myelitis
• Demyelinating sensorimotor neuropathy
• Ischemic stroke

Correct Answer: Acute Myelitis

Explaination: Peripheral neuropathy- presenting feature in almost all cases Distal predominant painful sensorimotor demyelinating neuropathy mimicking CIDP 35-45% are wheelchair bound at presentation<br>Papilledema- main ocular manifestation ; rarely at presentation; disc swelling possibly due to increased vascular permeability, increased proteins.-<br>20-30% cases report venous/arterial thromboembolism <br>Venous(DVT, PE, Catheter associated DVT),Arterial(POVD,MI, Ischemic Stroke)<br>Ischemic stroke- present before or within 3 months of diagnosis. Half are multifocal- Mechanism- large vessel stenosis and thromboembolism. Prophylactic LMWH and single antiplatelet are suggested at diagnosis and continued until anti-plasma cell therapy is initiated and VEGF < 1000pg/ml

Reference: Continuum : Neurology of systemic diseases( June 2023, Volume 29,no 3) Hematologic Disorders and the Nervous System Page 838-839.