Anti-NMDA Receptor Encephalitis


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6081068/

Brain on Fire: My Month of Madness by Susannah Cahalan

Anti-NMDA receptor encephalitis is an autoimmune condition that was only just discovered in 2007. While it has most likely been around for much longer, there is evidence that this condition is much more prevalent than realized, and the vast majority of patients with the symptoms of this disorder are misdiagnosed as psychiatric patients. The NMDA (N-methyl-D-aspartate) receptors in the brain play a role in the control of neurological electrical impulses. NMDA is a protein that contributes to judgement, perception of reality, human interaction, the formation and recollection of memory, and autonomic functions (breathing, hunger, etc). With anti-NMDA receptor encephalitis, the patient’s NDMA receptors are attacked by the patient’s own immune system, resulting in a swelling of the brain and a cascade of functional and cognitive impairments.

It has been recently discovered that this condition is usually triggered by an infection or tumor residing in another location within the patient’s body. 80% of those who suffer from anti-NMDA receptor encephalitis are women, and the majority of these women are found to have ovarian tumors – often teratomas, containing abnormal growths of other types of tissue (teeth, hair, brain tissue, etc). Other triggers could be viral, such as the herpes simplex virus. In a study published in August 2018, researchers found that the most important factor in recovery and remission was the removal of this seemingly unassociated tumor.

In the memoir Brain on Fire: My Month Of Madness by Susannah Cahalan (2012), the author tracks her life as she went from a rising New York journalist, to a catatonic psychiatric patient, to having a month completely missing form her memory and having to re-learn to walk, write, and talk. 

Susannah was only the 217th person ever to be diagnosed with anti-NMDA, but since that time, awareness and research on the topic has increased exponentially. In describing some of her symptoms – including hallucinations, frightening muscle contractures, aggression, seemingly “speaking in tongues”, and eventually catatonia – the author poses a very interesting question: how many reported cases of witchcraft and demonic possession were actually caused by anti-NMDA receptor encephalitis?

Comments

  1. I have never heard or learned about this before reading your blog post. Something I did want to know while reading through it, is whether this autoimmune condition is curable. I looked it up and found that some forms of this disease respond well to immune therapies but as time passes it may relapse. It is interesting how 80% of all the people with this disease are women. I wonder whether it has to do with our biological differences or any damage to our brains. It could also be correlated to ovarian tumors because you say the majority of the women do which is something to consider. Nice blog post.

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  2. I thought it was interesting that the patient's NDMA receptors are attacked by the patient's own immune system. This disease was also new to me but after doing some research I saw that it is an autoimmune disorder where antibodies attack NDMA, with NDMA standing for N-methyl-D-aspartate. One form of treatment is immunotherapy. The use of medications such as anticholinergics, benzodiazepines, and valproic acid have also been helpful.

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  3. Amanda,

    I've actually heard of this! I watched the movie for this memoir and it was very interesting. I'm so glad you posted about this, I wasn't sure if it was actually true. I highly recommend the movie to you since you've read a little about Anti-NMDA receptor encephalitis already.

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    Replies
    1. I had seen that there was a movie based on the book but I have not seen it yet. It is on my list. If you liked the movie I highly recommend the book if you haven't read it. It's terrifying and interesting at the same time, as I am sure the movie is.

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