title: Unilateral diaphragm paralysis possibly due to cervical spine involvement in multiple myeloma.
abstract: OBJECTIVE
  To describe a patient with unilateral diaphragmatic paralysis due to multiple myeloma (MM) involving the cervical spine and related structures.
  
  
  METHODS
  A 52-year-old female presented with dyspnea, low back and widespread bone pain. She was diagnosed as having MM with vertebral involvement and unilateral paralysis of the diaphragm. She received two cycles of a chemotherapeutic regimen consisting of vincristine-Adriamycin-dexamethasone. The bisphosphonate zoledronic acid was also initiated at the same time. During follow-up, the back pain disappeared and the complaint of dyspnea decreased, although the paralysis persisted.
  
  
  CONCLUSIONS
  As part of the differential diagnosis of bone and back pain, we draw attention to MMand the rare complication of diaphragmatic paralysis due to phrenic nerve involvement.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Kara
authors.forename: Metin
authors.initials: M
authors.lastname: Isik
authors.forename: Levent
authors.initials: L
authors.lastname: Ozcakar
authors.forename: Ozlem
authors.initials: O
authors.lastname: Erol
authors.forename: Serkan
authors.initials: S
authors.lastname: Dogan
authors.forename: Kadri
authors.initials: K
authors.lastname: Altundag
authors.forename: Salih
authors.initials: S
authors.lastname: Aksu
mesh_terms: D002574:Cervical Vertebrae; D003964:Diaphragm; D005260:Female; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D010243:Paralysis / Q000209:etiology*; D013125:Spinal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D013904:Thoracic Vertebrae