POST RESECTION PSYCHIATRIC SEQUELAE OF PROTOPLASMIC ASTROCYTOMA - A RARE TYPE OF GLIOMA- A CASE REPORT

INTRODUCTION. A variety of psychiatric symptoms are associated with brain tumours. The frequency of the association between brain tumours and behavioural disturbances depends significantly on the location of the tumour. Making the relationship between brain tumours and secondary behavioural changes is becoming more difficult due to the complications of various therapeutic interventions like extensive surgical resection of the tumour mass. We report a case of a rare variant of low grade glioma -protoplasmic astrocytoma, in the left frontal region presenting with various neuro psychiatric manifestations, particularly with neuro cognitive deficits and depression after surgical resection of the tumour. THE CASE. A 33yr old male, graduate, unmarried working in a private company had atypical depressive symptoms for about one year followed by focal seizures. He was later diagnosed to be having left frontal diffusely infiltrating protoplasmic astrocytoma grade II and surgical resection was done. Following surgery he had recurrent episodes of depression along with psychotic features and had weakness over right upper and lower limbs. He also had persistent anxiety symptoms and occasional aggressive outbursts. He was followed up for a period of two years during which he had three depressive episodes. Initially he was responding well to medications and later in the due course, he was becoming treatment resistant. He had severe neurocognitive deficits in the areas of attention, working memory and executive functioning assessed by various neuropsychological tests periodically. His cognitive deficits led to severe work impairment and loss of job.