What are the key clinical features that suggest a diagnosis of glioblastoma multiforme in a patient presenting with neurological symptoms?

Key clinical features suggesting glioblastoma multiforme (GBM) in a patient presenting with neurological symptoms include:

• New onset or progressive focal neurological deficits such as weakness, sensory loss, or speech difficulties, reflecting tumour location in the brain.
• Seizures, which may be a presenting symptom due to cortical irritation by the tumour.
• Headache, often worsening over weeks to months, sometimes associated with nausea or vomiting, indicating raised intracranial pressure.
• Cognitive or personality changes, including memory loss, confusion, or behavioural alterations, due to tumour infiltration of cerebral cortex.
• Rapid clinical deterioration over weeks, consistent with the aggressive nature of GBM.

These features arise because GBM is a high-grade, infiltrative primary brain tumour that commonly presents with a combination of focal neurological signs and symptoms of increased intracranial pressure ¹. The UK NICE guidelines emphasize the importance of suspecting high-grade glioma such as GBM in adults presenting with these neurological symptoms and recommend urgent MRI imaging for diagnosis ¹. Epidemiological and clinical studies also confirm that GBM typically presents with rapidly progressive neurological deficits and seizures, reflecting its aggressive growth and cortical involvement (Belghali et al., 2021; Chen et al., 2022).

In summary, the key clinical features are a combination of focal neurological deficits, seizures, headache, cognitive changes, and rapid progression, which should prompt urgent neuroimaging and specialist referral to confirm diagnosis and initiate management ¹ (Belghali et al., 2021; Chen et al., 2022).