She’d gone through “a million dollars’ worth of tests,” Dalmau recently recounted. By the time Dalmau arrived, she couldn’t speak and could breathe only with the aid of a ventilator. The woman had come in months before, agitated and hallucinating. Blood and foam began to spurt out of my mouth through clenched teeth.”īut the autoimmune disease wasn’t identified until Josep Dalmau, a neurologist at the University of Pennsylvania, was called to see a patient in the intensive care unit in 2002. ![]() Cahalan described her first seizure in a book about her experience, “Brain on Fire”: “My arms suddenly whipped straight out in front of me, like a mummy, as my eyes rolled back and my body stiffened. Some speculate anti-NMDA receptor encephalitis could be behind historical descriptions of what was believed to be demonic possession. The discovery of the disease “seems to be the beginning of a much larger story that is leading to a paradigm shift in neurology and psychiatry,” he said. ![]() “We are learning more even as we speak,” said Sander Markx, a psychiatrist at Columbia University who studies the genetics of psychiatric disorders, such as schizophrenia. But with aggressive therapies to suppress the immune system, most awaken to return to normal lives.Įxperts suggest that the disease and others like it - at the intersection of psychiatry and neurology - can broaden our understanding of the basis of psychosis and, perhaps, in some cases, its treatment. Some slip into a state of complete unresponsiveness. Patients could ultimately grow sick enough to require a breathing tube. Symptoms worsen to include agitation, paranoia, delusions, or hallucinations. It can begin subtly, with a change in behavior, often after a headache or flu-like illness. ![]() The disease typically strikes young women, but also can affect men and children. The protein, the NMDA receptor, helps neurons communicate it is the same receptor that’s blocked by PCP or ketamine - both drugs that can make a normal person act like someone with schizophrenia. Instead, they were found to have a newly described disease called anti-NMDA receptor encephalitis, caused when the body’s immune system goes haywire and attacks a protein in the brain. The women’s slow unraveling could have been the beginning of a psychotic break, followed by a lifetime of hospitalization and medication.
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