title: [Isolated sixth nerve palsy--presenting sign of multiple myeloma].
abstract: Multiple myeloma is a disease caused by neoplastic plasma cells. Initial symptoms in most cases described in the literature include chest and lumbar pain, paresthesia, paraplegia, general weakness and renal failure. We report a case of isolated sixth nerve palsy causing diplopia as the presenting sign of multiple myeloma. Awareness of such a rare clinical presentation - especially when the existence of multiple myeloma is ignored after visualization of a cranial mass with magnetic resonance imaging (MRI) and computerized tomography (CT)--can prevent unnecessary surgical intervention and delay the appropriate treatment.
authors.affiliation: Ophthalmology Department, Unit of Neuro-Ophthalmology, Rabin Medical Center Beilinson Campus, Petah Tikva. alonzahavi@gmail.com
authors.forename: Alon
authors.initials: A
authors.lastname: Zahavi
authors.forename: Riri S
authors.initials: RS
authors.lastname: Manor
authors.forename: Meir
authors.initials: M
authors.lastname: Lahav
authors.forename: Mati
authors.initials: M
authors.lastname: Bakon
authors.forename: Hadas
authors.initials: H
authors.lastname: Kalish
mesh_terms: D020434:Abducens Nerve Diseases / Q000175:diagnosis / Q000209:etiology*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology; D004172:Diplopia / Q000209:etiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000473:pathology; D014057:Tomography, X-Ray Computed