Ghandour Fatima, Squassina Alessio, Karaky Racha, Diab-Assaf Mona, Fadda Paola, Pisanu Claudia
Department of Biomedical Sciences, Division of Neuroscience and Clinical pharmacology, University of Cagliari, 09042 Monserrato, Italy.
EDST, Pharmacology and Cancerology Laboratory, Faculty of Sciences, Lebanese University, Beirut 1500, Lebanon.
Brain Sci. 2021 Feb 27;11(3):301. doi: 10.3390/brainsci11030301.
Brain tumors can present with various psychiatric symptoms, with or without neurological symptoms, an aspect that complicates the clinical picture. However, no systematic description of symptoms that should prompt a neurological investigation has been provided. This review aims to summarize available case reports describing patients with brain tumors showing psychiatric symptoms before brain tumor diagnosis, in order to provide a comprehensive description of these symptoms as well as their potential relationship with delay in the diagnosis. A systematic literature review on case reports of brain tumors and psychiatric symptoms from 1970 to 2020 was conducted on PubMed, Ovid, Psych Info, and MEDLINE. Exclusion criteria comprised tumors not included in the World Health Organization (WHO) Classification 4th edition and cases in which psychiatric symptoms were absent or followed the diagnosis. A total of 165 case reports were analyzed. In a subset of patients with brain tumors, psychiatric symptoms can be the only manifestation or precede focal neurological signs by months or even years. The appearance of focal or generalized neurological symptoms after, rather than along with, psychiatric symptoms was associated with a significant delay in the diagnosis in adults. A timely assessment of psychiatric symptoms might help to improve early diagnosis of brain tumors.
脑肿瘤可伴有各种精神症状，无论有无神经症状，这一情况使临床症状变得复杂。然而，尚未有关于哪些症状应促使进行神经学检查的系统描述。本综述旨在总结现有病例报告，这些报告描述了在脑肿瘤诊断前出现精神症状的患者，以便全面描述这些症状以及它们与诊断延迟的潜在关系。我们在PubMed、Ovid、Psych Info和MEDLINE上对1970年至2020年有关脑肿瘤和精神症状的病例报告进行了系统的文献综述。排除标准包括未列入世界卫生组织（WHO）第4版分类的肿瘤以及无精神症状或在诊断后出现精神症状的病例。总共分析了165份病例报告。在一部分脑肿瘤患者中，精神症状可能是唯一表现，或者比局灶性神经体征早出现数月甚至数年。在成人中，精神症状之后而非与之同时出现局灶性或全身性神经症状与诊断的显著延迟有关。及时评估精神症状可能有助于改善脑肿瘤的早期诊断。
