Late onset acute psychosis secondary to primary brain tumour: An initial misdiagnosis

Kuehn, Rebecca

doi:10.1177/0004867414549964

Cited by 3 publications

(8 citation statements)

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“…Mood disorders were associated with tumours involving the frontal lobes,10 12–14 22–25 34 temporal lobes14 16 17 20 30 and limbic structures 17 31. Patients manifested psychotic symptoms in 35% (9/26) of cases 11 15 22 25–28 30 32. Psychotic symptoms tended to be predominantly associated with tumours localised in the temporal lobes,15 26 27 30 31 although some of the cases reported here also traced the emergence of psychotic symptoms to tumours predominantly effecting the frontal lobes11 22 25 and corpus callosum 28 32.…”

Section: Discussionmentioning

confidence: 67%

“…The emergence of psychiatric symptoms may be the initial, and often insidious, sign of an evolving GBM. In several of the cases summarised here, it was the psychiatric symptoms that prompted clinical presentation 3 10 13 14 16 17 20–23 26–28 30 31. Psychiatric manifestations related to GBM in the cases retrieved here have been reported in adults whose ages spanned 24–65 years; most (62%) of the afflicted persons were middle-aged.…”

Section: Discussionmentioning

confidence: 74%

“…Patients manifested psychotic symptoms in 35% (9/26) of cases 11 15 22 25–28 30 32. Psychotic symptoms tended to be predominantly associated with tumours localised in the temporal lobes,15 26 27 30 31 although some of the cases reported here also traced the emergence of psychotic symptoms to tumours predominantly effecting the frontal lobes11 22 25 and corpus callosum 28 32. There was a paucity of GBM cases involving the parietal lobe and none involving the occipital lobes; it has been argued that such tumours tend to be relatively ‘silent’ with regard to psychiatric manifestations 17 31 35 36…”

Section: Discussionmentioning

confidence: 79%

“…Due to the effects of increased intracranial pressure, brain neoplasm classically presents with generalised symptoms, that is, headache, vomiting and seizure 3 10–18. Fast-growing tumours, particularly within the frontal lobe and corpus callosum3 19 can produce cognitive changes3 10 12 16 20 21 and/or neurological signs12 13 17 18 22–29 but these may not be appreciable until the tumour becomes quite large. Subtle and atypical neuropsychiatric symptoms may predominate early in the course of tumour growth/expansion.…”

Section: Discussionmentioning

confidence: 99%

“…Depression was the primary psychiatric symptom manifestation of the underlying GBM in 62% (16/26) of retrieved cases 3 10 13 14 16–18 20–23 25 28 30 32 33. Other mood disturbances reported among GBM patients included pseudobulbar affect-like states,24 manic-like states27 31 and anxiety,3 12 13 17 34 some of the latter of which co-occurred in depressed patients. Mood disorders were associated with tumours involving the frontal lobes,10 12–14 22–25 34 temporal lobes14 16 17 20 30 and limbic structures 17 31.…”

Section: Discussionmentioning

confidence: 99%

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Subtle neuropsychiatric symptoms of glioblastoma multiforme misdiagnosed as depression

2020

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Glioblastoma multiforme (GBM) is the most common of the aggressive primary brain tumours arising in adults and has a dire prognosis. Neuropsychiatric symptoms can vary significantly among afflicted persons; psychiatric disturbances may be the predominant presenting symptoms. Distinguishing between functional psychiatric disorders, particularly depression, from other subtle neuropsychiatric disturbances that may accompany GBM can be challenging. The authors present a clinical case and review of the literature in an attempt to highlight the special considerations that should be taken into account when evaluating patients who present with late-onset or atypical symptoms, refractory psychiatric symptoms, or subtle neurological disturbances signalling the need for diagnostic assessment, particularly neuroimaging, for the presence of a tumour. Early diagnosis is critical for improvement in quality of life.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Subtle neuropsychiatric symptoms of glioblastoma multiforme misdiagnosed as depression

2020

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Comparison of Oncogenes, Tumor Suppressors, and MicroRNAs Between Schizophrenia and Glioma: The Balance of Power

Brown¹

2023

Neuroscience & Biobehavioral Reviews

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The clinical utility of structural neuroimaging in first-episode psychosis: A systematic review

Forbes

Stefler

Velakoulis

et al. 2019

Aust N Z J Psychiatry

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Background: Australian and US guidelines recommend routine brain imaging, either computed tomography or magnetic resonance imaging, to exclude structural lesions in presentations for first-episode psychosis. The aim of this review was to examine the evidence for the appropriateness and clinical utility of this recommendation by assessing the frequency of abnormal radiological findings in computed tomography and magnetic resonance imaging scans among patients with first-episode psychosis. Methods: PubMed and Embase database were searched from inception to April 2018 using appropriate MeSH or Emtree terms. Studies were included in the review if they reported data on computed tomography or magnetic resonance imaging scan findings of individuals with first-episode psychosis. No restriction on the geographical location of the study or the age of participants was applied. We calculated the percentage of abnormal radiological findings in each study, separately by the two diagnostic methods. Results: There were 16 suitable studies published between 1988 and 2017, reporting data on an overall 2312 patients with first-episode psychosis. Most were observational studies with a retrospective design and the majority examined patients with computed tomography. While structural abnormalities were a relatively common finding, these rarely required clinical intervention (range across studies: 0–60.7%; median: 3.5%) and were very rarely the cause of the psychotic symptoms (range: 0–3.3%; median: 0%). Only 2 of the 16 studies concluded that brain imaging should be routinely ordered in first-episode psychosis. Conclusion: There is insufficient evidence to suggest that brain imaging should be routinely ordered for patients presenting with first-episode psychosis without associated neurological or cognitive impairment. The appropriate screening procedure for structural brain lesions is conventional history-taking, mental status and neurological examination. If intracranial pathology is suspected clinically, a magnetic resonance imaging or computed tomography scan should be performed depending on the clinical signs, the acuity and the suspected pathology. National guidelines should reflect evidence-based data.

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Late onset acute psychosis secondary to primary brain tumour: An initial misdiagnosis

Cited by 3 publications

References 1 publication

Subtle neuropsychiatric symptoms of glioblastoma multiforme misdiagnosed as depression

Subtle neuropsychiatric symptoms of glioblastoma multiforme misdiagnosed as depression

Comparison of Oncogenes, Tumor Suppressors, and MicroRNAs Between Schizophrenia and Glioma: The Balance of Power

The clinical utility of structural neuroimaging in first-episode psychosis: A systematic review

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