Study Design: Case series. Objective: To compare transcranial magnetic stimulation (TMS) and magnetic resonance imaging (MRI) findings between patients who underwent surgery for cervical spondylotic myelopathy and those with spondylosis who were not operated upon, and to correlate these findings with clinical functionality at follow-up. Setting: Private practice. Methods: Of 16 consecutive patients with cervical spondylosis 8 underwent surgery (group I) and 8 were treated conservatively (group II). We compared TMS and MRI findings between these groups and we correlated central motor conduction times (CMCTs) and MRImeasured sagittal and parasagittal diameters of the spinal canal at baseline evaluation, with clinical functionality at 2-year follow-up. Results: Group I CMCTs at the lower limbs correlated significantly with modified-JoA 2 years post surgery (r = − 0.71, Po0.05), but MRI-measured diameters did not. In group II baseline TMS was unrevealing, contrary to significant spinal stenosis disclosed by MRI. The condition of none of these patients deteriorated at 2 years. Conclusions: CMCTs at the lower limbs, but not cervical spinal canal diameters, correlate with long-term functional outcome following surgical or conservative treatment. Spinal Cord (2015) 53, S16-S18; doi:10.1038/sc.2014.220 INTRODUCTIONWhether magnetic resonance imaging (MRI) and transcranial magnetic stimulation (TMS) can predict long-term clinical outcomes in patients with cervical spondylosis is an issue of debate. 1-3 We compared TMS and MRI findings between a group of patients who underwent surgery for cervical spondylotic myelopathy and a second group with spondylosis, who were not operated upon, and we correlated these abnormalities with longitudinal clinical follow-up.

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Multiple sclerosis (MS) has been reported in association with haematological abnormalities, including monoclonal gammopathies. We present a 54-year-old male patient with a 30-year history of MS who was admitted to our hospital for investigation of anaemia and increased erythrocyte sedimentation rate. A monoclonal IgM protein was detected by serum protein immunofixation, while bone marrow biopsy indicated a 70% infiltration by small lymphoplasmacytoid cells, in the context of a lymphoplasmacytoid immunocytoma, findings compatible to the diagnosis of Waldenström's macroglobulinemia (WM). To our knowledge, this is the first report of WM in a patient with MS. Further to the coexistence of the two diseases observed in the case presented here, there is additional evidence suggesting that the association of MS with plasma cell dyscrasias may not be coincidental.