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 NICE NG99. 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 NICE NG99. 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. 2021Chen 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 NICE NG99 Belghali et al. 2021Chen et al. 2022.