A 53-year-old gentleman is described, who presented with acute onset o
f anxiety and obsessional symptoms. The clinical picture was complicat
ed by the presence of mild alcohol withdrawal symptoms and history of
excessive drinking for 20 years. A month later, he developed right hem
iparesis. CT scan revealed a left frontal tumour, and on histology thi
s was found to be Grade 4 astrocytoma.