{"id":"https://openalex.org/W3016005052","doi":"https://doi.org/10.1212/wnl.0000000000009376","title":"Clinical Reasoning: A 59-year-old woman with multiple myeloma and lower extremity weakness and numbness","display_name":"Clinical Reasoning: A 59-year-old woman with multiple myeloma and lower extremity weakness and numbness","publication_year":2020,"publication_date":"2020-04-14","ids":{"openalex":"https://openalex.org/W3016005052","doi":"https://doi.org/10.1212/wnl.0000000000009376","mag":"3016005052","pmid":"https://pubmed.ncbi.nlm.nih.gov/32284358"},"language":"en","primary_location":{"id":"doi:10.1212/wnl.0000000000009376","doi":"https://doi.org/10.1212/wnl.0000000000009376","is_oa":true,"landing_page_url":"https://doi.org/10.1212/wnl.0000000000009376","pdf_url":"https://n.neurology.org/content/neurology/94/18/794.full.pdf","source":{"id":"https://openalex.org/S79704628","display_name":"Neurology","issn_l":"0028-3878","issn":["0028-3878","1526-632X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Neurology","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"bronze","oa_url":"https://n.neurology.org/content/neurology/94/18/794.full.pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5052770525","display_name":"Ron Gadot","orcid":"https://orcid.org/0000-0001-6480-3521","observed_orcids":["https://orcid.org/0000-0001-6480-3521"]},"institutions":[{"id":"https://openalex.org/I181547552","display_name":"Baylor College of Medicine","ror":"https://ror.org/02pttbw34","country_code":"US","type":"education","lineage":["https://openalex.org/I181547552","https://openalex.org/I2801539370"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Ron Gadot","raw_affiliation_strings":["From Baylor College of Medicine School of Medicine (R.G.); and the Department of Neurology (R.G., F.A.N., K.N.-W.) and Section of Hematology and Oncology, Department of Medicine (M.M.), Baylor College of Medicine, Houston, TX","From Baylor College of Medicine School of Medicine (R.G.)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"From Baylor College of Medicine School of Medicine (R.G.); and the Department of Neurology (R.G., F.A.N., K.N.-W.) and Section of Hematology and Oncology, Department of Medicine (M.M.), Baylor College of Medicine, Houston, TX","institution_ids":["https://openalex.org/I181547552"]},{"raw_affiliation_string":"From Baylor College of Medicine School of Medicine (R.G.)","institution_ids":["https://openalex.org/I181547552"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5084737337","display_name":"F\u00e1bio Augusto Nascimento","orcid":"https://orcid.org/0000-0002-7161-6385","observed_orcids":["https://orcid.org/0000-0002-7161-6385"]},"institutions":[{"id":"https://openalex.org/I181547552","display_name":"Baylor College of Medicine","ror":"https://ror.org/02pttbw34","country_code":"US","type":"education","lineage":["https://openalex.org/I181547552","https://openalex.org/I2801539370"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"F\u00e1bio A. Nascimento","raw_affiliation_strings":["From Baylor College of Medicine School of Medicine (R.G.); and the Department of Neurology (R.G., F.A.N., K.N.-W.) and Section of Hematology and Oncology, Department of Medicine (M.M.), Baylor College of Medicine, Houston, TX","From Baylor College of Medicine School of Medicine (R.G.)"],"raw_orcid":"https://orcid.org/0000-0002-7161-6385","affiliations":[{"raw_affiliation_string":"From Baylor College of Medicine School of Medicine (R.G.); and the Department of Neurology (R.G., F.A.N., K.N.-W.) and Section of Hematology and Oncology, Department of Medicine (M.M.), Baylor College of Medicine, Houston, TX","institution_ids":["https://openalex.org/I181547552"]},{"raw_affiliation_string":"From Baylor College of Medicine School of Medicine (R.G.)","institution_ids":["https://openalex.org/I181547552"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5110886100","display_name":"Martha Pritchett Mims","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I181547552","display_name":"Baylor College of Medicine","ror":"https://ror.org/02pttbw34","country_code":"US","type":"education","lineage":["https://openalex.org/I181547552","https://openalex.org/I2801539370"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Martha Mims","raw_affiliation_strings":["From Baylor College of Medicine School of Medicine (R.G.); and the Department of Neurology (R.G., F.A.N., K.N.-W.) and Section of Hematology and Oncology, Department of Medicine (M.M.), Baylor College of Medicine, Houston, TX","From Baylor College of Medicine School of Medicine (R.G.)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"From Baylor College of Medicine School of Medicine (R.G.); and the Department of Neurology (R.G., F.A.N., K.N.-W.) and Section of Hematology and Oncology, Department of Medicine (M.M.), Baylor College of Medicine, Houston, TX","institution_ids":["https://openalex.org/I181547552"]},{"raw_affiliation_string":"From Baylor College of Medicine School of Medicine (R.G.)","institution_ids":["https://openalex.org/I181547552"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5047298231","display_name":"Karen R. Nunez-Wallace","orcid":"https://orcid.org/0000-0003-2114-4735","observed_orcids":["https://orcid.org/0000-0003-2114-4735"]},"institutions":[{"id":"https://openalex.org/I181547552","display_name":"Baylor College of Medicine","ror":"https://ror.org/02pttbw34","country_code":"US","type":"education","lineage":["https://openalex.org/I181547552","https://openalex.org/I2801539370"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Karen Nunez-Wallace","raw_affiliation_strings":["From Baylor College of Medicine School of Medicine (R.G.); and the Department of Neurology (R.G., F.A.N., K.N.-W.) and Section of Hematology and Oncology, Department of Medicine (M.M.), Baylor College of Medicine, Houston, TX","From Baylor College of Medicine School of Medicine (R.G.)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"From Baylor College of Medicine School of Medicine (R.G.); and the Department of Neurology (R.G., F.A.N., K.N.-W.) and Section of Hematology and Oncology, Department of Medicine (M.M.), Baylor College of Medicine, Houston, TX","institution_ids":["https://openalex.org/I181547552"]},{"raw_affiliation_string":"From Baylor College of Medicine School of Medicine (R.G.)","institution_ids":["https://openalex.org/I181547552"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I181547552"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":2,"citation_normalized_percentile":{"value":0.04763916,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":95,"max":97},"biblio":{"volume":"94","issue":"18","first_page":"794","last_page":"800"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10649","display_name":"Multiple Myeloma Research and Treatments","score":0.9307000041007996,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10649","display_name":"Multiple Myeloma Research and Treatments","score":0.9307000041007996,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11735","display_name":"Peripheral Neuropathies and Disorders","score":0.06030000001192093,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13533","display_name":"Medical Case Reports and Studies","score":0.004399999976158142,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/multiple-myeloma","display_name":"multiple myeloma","score":0.9919999837875366},{"id":"https://openalex.org/keywords/igg-lambda","display_name":"IgG lambda","score":0.5839999914169312},{"id":"https://openalex.org/keywords/bortezomib","display_name":"bortezomib","score":0.9269999861717224},{"id":"https://openalex.org/keywords/lower-limb-weakness","display_name":"lower limb weakness","score":0.718999981880188},{"id":"https://openalex.org/keywords/hypoesthesia","display_name":"numbness","score":0.8479999899864197},{"id":"https://openalex.org/keywords/peripheral-neuropathy","display_name":"peripheral neuropathy","score":0.7799999713897705},{"id":"https://openalex.org/keywords/drug-induced-neuropathy","display_name":"drug-induced neuropathy","score":0.7110000252723694},{"id":"https://openalex.org/keywords/gait-disturbance","display_name":"gait disturbance","score":0.6060000061988831},{"id":"https://openalex.org/keywords/falls","display_name":"falls","score":0.8399999737739563},{"id":"https://openalex.org/keywords/chronic-back-pain","display_name":"chronic back pain","score":0.4959999918937683}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8882911205291748},{"id":"https://openalex.org/C2780247198","wikidata":"https://www.wikidata.org/wiki/Q633403","display_name":"Weakness","level":2,"score":0.8337163329124451},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.6072096824645996},{"id":"https://openalex.org/C2776364478","wikidata":"https://www.wikidata.org/wiki/Q467635","display_name":"Multiple myeloma","level":2,"score":0.5417041182518005},{"id":"https://openalex.org/C2776418732","wikidata":"https://www.wikidata.org/wiki/Q270421","display_name":"Muscle weakness","level":2,"score":0.4396061599254608},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.17080238461494446}],"mesh":[{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006987","descriptor_name":"Hypesthesia","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":true},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009101","descriptor_name":"Multiple Myeloma","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":true},{"descriptor_ui":"D011129","descriptor_name":"Polyradiculoneuropathy","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":true},{"descriptor_ui":"D018908","descriptor_name":"Muscle Weakness","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":true},{"descriptor_ui":"D035002","descriptor_name":"Lower Extremity","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1212/wnl.0000000000009376","doi":"https://doi.org/10.1212/wnl.0000000000009376","is_oa":true,"landing_page_url":"https://doi.org/10.1212/wnl.0000000000009376","pdf_url":"https://n.neurology.org/content/neurology/94/18/794.full.pdf","source":{"id":"https://openalex.org/S79704628","display_name":"Neurology","issn_l":"0028-3878","issn":["0028-3878","1526-632X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Neurology","raw_type":"journal-article"},{"id":"pmid:32284358","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/32284358","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Neurology","raw_type":"Case Reports"}],"best_oa_location":{"id":"doi:10.1212/wnl.0000000000009376","doi":"https://doi.org/10.1212/wnl.0000000000009376","is_oa":true,"landing_page_url":"https://doi.org/10.1212/wnl.0000000000009376","pdf_url":"https://n.neurology.org/content/neurology/94/18/794.full.pdf","source":{"id":"https://openalex.org/S79704628","display_name":"Neurology","issn_l":"0028-3878","issn":["0028-3878","1526-632X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Neurology","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9940000176429749,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Case Report","id":"https://openalex.org/study-designs/case-report"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W3016005052.pdf","grobid_xml":"https://content.openalex.org/works/W3016005052.grobid-xml"},"referenced_works_count":10,"referenced_works":["https://openalex.org/W2048412481","https://openalex.org/W2056879598","https://openalex.org/W2084842992","https://openalex.org/W2088110780","https://openalex.org/W2094425590","https://openalex.org/W2144728882","https://openalex.org/W2487685184","https://openalex.org/W2611398699","https://openalex.org/W4211208596","https://openalex.org/W4238374426"],"related_works":["https://openalex.org/W7204201674","https://openalex.org/W185641317","https://openalex.org/W2724270257","https://openalex.org/W2996816803","https://openalex.org/W4399988900","https://openalex.org/W2921231986","https://openalex.org/W2602068066","https://openalex.org/W2906230237","https://openalex.org/W1516560111","https://openalex.org/W2622326670"],"abstract_inverted_index":{"A":[0],"59-year-old":[1],"woman":[2],"with":[3,18,37],"a":[4],"history":[5,94],"of":[6,42,95],"stage":[7],"3":[8,40],"immunoglobulin":[9],"G":[10],"(IgG)":[11],"lambda":[12],"multiple":[13],"myeloma":[14],"(MM)":[15],"on":[16],"treatment":[17],"bortezomib":[19,118],"and":[20,26,34,47,59,103,109],"dexamethasone,":[21],"chronic":[22,27],"lower":[23,31,44,66,73,100],"back":[24],"pain,":[25],"but":[28],"improving":[29],"bilateral":[30,99],"extremity":[32,45,67,101],"weakness":[33,46,102],"numbness":[35,76,104],"presented":[36],"2":[38],"to":[39,50,70,125],"weeks":[41],"worsening":[43],"numbness.":[48],"Prior":[49],"presentation,":[51],"the":[52,64,71],"patient":[53],"had":[54,119],"been":[55,120],"hospitalized":[56],"for":[57,114],"sepsis":[58],"cardiac":[60],"arrest.":[61],"Weakness":[62],"affected":[63],"left":[65],"before":[68],"progressing":[69],"right":[72],"extremity,":[74],"whereas":[75],"was":[77,83],"present":[78],"in":[79,106],"both":[80],"feet.":[81],"There":[82],"no":[84],"bowel":[85],"or":[86,93],"bladder":[87],"incontinence,":[88],"saddle":[89],"anesthesia,":[90],"preceding":[91],"trauma,":[92],"radiation":[96],"therapy.":[97],"The":[98],"resulted":[105],"gait":[107],"impairment":[108],"falls,":[110],"which":[111],"prompted":[112],"admission":[113],"further":[115],"investigation.":[116],"Notably,":[117],"started":[121],"4":[122],"months":[123],"prior":[124],"presentation.":[126]},"counts_by_year":[{"year":2026,"cited_by_count":2}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2020-04-17T00:00:00"}