GLIOBLASTOMA MULTIFORME PRESENTING WITH PSYCHIATRIC SYMPTOMS

BACKGROUND Tumours of the brain may present with symptoms resembling psychosis and depression. Glioblastoma is the commonest infiltrative astrocytoma. CASE REPORT Mr. K, 52 years, was brought by relatives reported with low mood, retarded activity, interest and concentration. He also featured with monosyllabic responses, postural difficulties, weakness of limbs and incontinence of urine. These complaints were preceded by vomiting and headache and there was no history of seizures, head injury or psychosis. He was recently diagnosed as diabetic 1 month back. On Central Nervous System examination, he presented with Left Lateral Rectus palsy, power of 4 out of 5 on Left Upper Limb and Left Lower Limb, apraxic gait, cortical bladder and bilateral papilloedema. On Mental Status Examination, he was lethargic with decreased psychomotor activity, monosyllabic responses, depressed mood and equivocal orientation and poor memory. Organicity was considered and MRI brain confirmed the diagnosis of Glioblastoma multiforme- grade IV which was correlated with histopathological studies. DISCUSSION This report illustrates the importance of ruling out the possibility of organic aetiology when confronted with the initial vague psychiatric symptoms in a person above 50 years without any preceding history of psychiatric disorder in the absence of family history.