A 57 y.o. F presenting with altered memory and difficulty reading which has been occurring over the past 2-3 months. On neurologic workup, a large left-sided temporal lobe lesion was noted on MRI. Craniotomy and resection were performed and patient was found to have a stage IV GBM (glioblastoma multiforme). \u00a0She was treated with steroids and Keppra in the post-operative period and discharged.<\/p>\n
2 weeks later she was seen in clinic and noted to be hyperactive with reports of 2-3 hours of sleep, was spending money excessively and was irritable. Given her recent steroid use, it was thought that this was steroid-induced psychosis and dexamethasone was discontinued. The manic-type behavior continued over the next 2 weeks and the patient was admitted to the Heme\/Onc ward service.<\/p>\n
Some sort of behavioral abnormality is seen in about 27% of all patients taking oral steroids. Manic behavior s occur in about 25% of those people. Without medication, steroid psychosis can take 2 weeks to 6 months to resolve. With medications (i.e. anti-psychotics) these side effects can be cut to a matter of days.<\/p>\n