LATE-ONSET PSYCHIATRIC MANIFESTATIONS OF ENCEPHALOMALACIA AND GLIOSIS WITH UNCERTAIN ETIOLOGY

Background: Encephalomalacia refers to the loss of brain tissue resulting from liquefactive necrosis, which can occur due to a variety of insults including trauma, infarction, infection, or haemorrhage. This process may also lead to gliosis, and such changes are typically evident on CT or MRI scans, which remain the primary diagnostic modalities. Clinical presentation varies depending on the location and extent of brain involvement, ranging from seizures and focal neurological deficits to psychiatric manifestations, as observed in this case. Chronic encephalomalacia is most commonly associated with hypoxic injury sustained during birth or infancy, but when presenting later in life with isolated psychiatric symptoms, it can pose a significant diagnostic challenge. This case highlights the importance of considering underlying organic causes in psychiatric presentations and emphasizes a thorough diagnostic approach prior to initiating treatment.