Apathy or depression? Do you have a nose for it? Four case reports of paramedian frontal tumors

We report four cases of patients with clinically isolated apathy which was mistaken for depression even though they were suffering from voluminous brain tumors. These cases remind us that rigorous clinical analysis is essential: searching for signs of organic origin or psychiatric etiology is fundam...

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Bibliographic Details
Published in:Revue neurologique 2010-08, Vol.166 (8-9), p.704-710
Main Authors: Cretin, B, Echaniz-Laguna, A, Meyer, C, Blanc, F, Sellal, F
Format: Article
Language:fre
Subjects:
Adenocarcinoma - complications
Adenocarcinoma - diagnosis
Adenocarcinoma - psychology
Adenocarcinoma - secondary
Aged
Cognition Disorders - etiology
Decision Trees
Depression - diagnosis
Diagnostic Errors
Diagnostic Imaging
Epistaxis - etiology
Ethmoid Sinus - pathology
Fatal Outcome
Female
Frontal Lobe - pathology
Frontal Lobe - physiopathology
Humans
Lethargy - diagnosis
Lethargy - etiology
Male
Meningeal Neoplasms - complications
Meningeal Neoplasms - diagnosis
Meningeal Neoplasms - psychology
Meningioma - complications
Meningioma - diagnosis
Meningioma - psychology
Middle Aged
Olfaction Disorders - etiology
Olfaction Disorders - physiopathology
Paranasal Sinus Neoplasms - diagnosis
Paranasal Sinus Neoplasms - pathology
Supratentorial Neoplasms - complications
Supratentorial Neoplasms - diagnosis
Supratentorial Neoplasms - psychology
Supratentorial Neoplasms - secondary
Tumor Burden
Vision Disorders - etiology
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Description
Summary:We report four cases of patients with clinically isolated apathy which was mistaken for depression even though they were suffering from voluminous brain tumors. These cases remind us that rigorous clinical analysis is essential: searching for signs of organic origin or psychiatric etiology is fundamental to avoid an incorrect diagnosis. In particular, these four patients displayed anosmia, an uncommon symptom for patients suffering from depression. In addition, brain imaging is important to correctly identify the most prudent medical and/or surgical management strategy. In this short discussion, we propose an algorithm for the clinical diagnosis of apathy.
ISSN:0035-3787
DOI:10.1016/j.neurol.2010.03.014