Expert: Claes-Gustaf Nordquist, M.D. - 1/4/2009

Question
Hello and thank you in advance for taking the time to answer my questions.  Your candor is refreshing and I appreciate the honesty you operate with.  I have an 83 year old grandfather who 2 weeks ago was diagnosed with Stage 4 GBM.  The tumor was attached to the right frontal and parietal lobe.  The Doctor decided to perform a debulking procedure and implanted the wafers. (one week ago)  He was able to remove 90% of the tumor and was quite pleased with how the procedure went and how he responded to the surgery.  At first it appeared things were going really well and then he started to become more and more confused.  Two day ago he went into a state where he started repeating letters and could not say anything else.  Then it progressed where he seems awake (eyes open) but nothing is going on.  This will last for hours and then all of a sudden he comes out of it and acts like everything is normal.  He may be with us for a few hours and then you can see it coming, he starts stuttering and talking fast and not making sense and then the light goes out.  No one seems to know what is happening when this happens.  Do you have any ideas?  Is this a form of a coma?  I fear the end is near and his time has come.  Thanks.

Answer
It may be some kind of epileptic variation. Epileptic fits are not unkommon with brain tumors or brain surgery. But you must understand that this is very much a speculation from my side. A GRADE 4 (brain tumors do not normally have stages) glioblastoma multiforme (GBM) has a very poor prognosis regardless of therapy so unfortunately I can not offer you any hope in this case.