Oligodendroglioma history and symptoms

When evaluating a patient for oligodendroglioma, a detailed history of the presenting symptom (onset, duration, and progression), other associated symptoms, a thorough past medical history review, and review of common risk factors such as family history of brain tumors. Oligodendroglioma is a slow–growing, infiltrative tumor that may be clinically silent for many years. With tumor progression, symptoms may vary depending upon the location, size, and rate of tumor growth. Oligodendroglioma mainly involves the frontal lobe. Symptoms associated with oligodendroglioma include seizure, headache, nausea, vomiting, vertigo, visual loss, diplopia, strabismus, muscle weakness, numbness, speech difficulties, mood disturbances, personality changes, memory problems, low energy, fatigue, urge to sleep, loss of interest in daily activities, abulia, lack of spontaneity, loss of consciousness with syncope (few tonic-clonic jerks), and classic triad of headache, nausea, and papilledema due to raised intracranial pressure.

• While evaluating a patient for oligodendroglioma, a detailed history of the following should be taken:^[1]
  • Presenting symptom:
    • Onset
    • Duration
    • Progression
  • Other associated symptoms
  • A thorough past medical history review
  • Review of common risk factors such as:
    • Family history of brain tumors

• Oligodendroglioma is a slow-growing, infiltrative tumor that may be clinically silent for many years
• Asymptomatic patients are diagnosed based on incidental findings at the time of brain imaging performed for another reason (e.g: trauma, migraine headaches)
• Focal neurologic deficits and generalized symptoms such as headache are uncommon at the time of diagnosis
• With tumor progression, symptoms may vary depending on following characteristics of tumor:
  • Location
  • Size
  • Rate of tumor growth
• It mainly involves the frontal lobe
• Common symptoms associated with oligodendroglioma include:^{[2][3][4][5][6]}
  • Seizure (usually the first and most common presentation in 50-80% of the cases)^[7]
  • Headache
  • Nausea
  • Vomiting
  • Vertigo
  • Focal neurological deficits depending upon tumor location (symptoms usually caused by local tissue disruption, mass effect on nearby structures, or vasogenic edema) include:
    • Muscle weakness
    • Numbness/sensory loss
    • Changes in speech/aphasia
    • Visual loss/visual spatial dysfunction
    • Diplopia
    • Strabismus
  • Cognitive dysfunction includes:
    • Memory problems
    • Changes in mood
    • Changes in personality
    • Low energy
    • Fatigue
    • Urge to sleep
    • Loss of interest in daily activities
    • Abulia (showing abnormal inability to act or make decisions)
    • Lack of spontaneity
  • Increased intracranial pressure (either due to a large mass or any restriction in cerebrospinal fluid outflow causing hydrocephalus) associated with following symptoms:
    • Classic triad that includes:
      • Headache
      • Nausea
      • Papilledema
    • Loss of consciousness with syncope (maybe associated with a few tonic-clonic jerks)

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