A case of Astrocytoma presented with Psychosis

INTRODUCTION: Astrocytoma is a tumour that grow from astrocyte. Astrocytes have regulatory role of brain function that are implicated in neurogenesis and synaptogenesis and maintaining homeostasis. Neuropsychiatric manifestation like headache, memory loss, seizure, change in mental status, visual problem, cognitive and motor impairment occur in astrocytoma. CASE REPORT: A 30-year-old female patient was presented with hearing of voices, feeling that people are talking about her, someone was pulling her hair, visualizing people, irritability, anger outburst, sleep disturbance and headache since last 10 months. She was diagnosed as a Schizophrenia and prescribed Risperidone 2mg and clonazepam 0.5mg. There were marked improvement in all the symptoms but patient developed amenorrhea after 5 months. So, we stopped Risperidone and started Aripiprazole 5mg which was continued for another 6 months. On one day patient had a seizure, blurring of vision, difficulty in gait. Patient was investigated and on MRI, a midline cerebellar vermis peripherally enhancing lesion with compression of 4(th) ventricle with moderate degree obstructive hydrocephalus suggestive of Astrocytoma was found. Patient was referred to neurosurgery for astrocytoma and was operated. CONCLUSION: A patient presented with psychiatric complaints should be thoroughly investigated for organicity.