Auto-Immune Disease Mistaken For Psychotic Symptoms When Journalist Behaves Oddly

June 6, 2016 6:57 PM

Filed Under: Brain On Fire, Dr. Max Gomez, Immune Disease

NEW YORK (CBSNewYork) — Imagine being a bright, young journalist with your entire life ahead of you. Then, suddenly you start behaving oddly, and doctors think you’re becoming psychotic.

As CBS2’s Dr. Max Gomez explained, for one woman, it was an attack on the brain by her immune system.

Psychiatric symptoms that are actually a biological disease are an under-appreciated and under-diagnosed problem.

One young New Yorker could have been institutionalized, had she not been seen by a very smart neurologist who suspected something else and saved her life.

Undergoing a neurological exam is routine and completely normal for Susannah Cahalan, but 7 years ago it would have been anything but.

It started with mood swings.

“One moment I would be you know, kind of hysterically happy, and then the next moment I would be despondent. I couldn’t control my emotions,” she said.

Shortly thereafter Cahalan had her first seizure and was hospitalized where her behavior became even more erratic.

“I was, you know kicking and punching nurses, trying to escape. I believed you know, nurses were turning into people, and playing tricks on me. I was seeing things that weren’t there,” she said.

When Dr. Souhel Najjar saw her, he suspected a biological cause to her behavior, so he asked her to draw a clock.

Cahalan’s drawing suggested that something was affecting just one side of her brain.

A small brain biopsy revealed inflammation around the blood vessels in the brain.

“Disruption of the blood-brain barrier, which is essentially the wall between the periphery and the brain. It prevents harmful substances in the blood to enter into the brain,” Dr. Najjar explained.

The break in the barrier left Cahalan’s brain open to attack by her immune system, leading to a massive encephalitis. More tests were followed by immune suppressing drugs and treatment to wash outt he attacking anti-bodies.“She’s fully normal. She has no neurological deficiency of any kind,” Dr. Najjar said.

Cahalan doesn’t remember much of her time in the hospital, but she knows how close she came to permanent brain damage.

“I mean I could have been cognitively impaired and put in a nursing home for the rest of my life, and I’m not. I’m here, and I’m very grateful for that fact,” she said.

Cahalan and Dr. Najjar were at different hospitals back then. Today Dr. Najjar has established one of the very few clinics for brain auto-immune diseases at Lenox Hill Hospital.

Cahalan wrote a book called ‘Brain On Fire’ that has been made into a major motion picture to be released later this year.

http://newyork.cbslocal.com/2016/06/06/auto-immune-disease-mistaken-for-psychotic-symptoms-when-journalist-behaves-oddly/