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Doctors Close To Understanding Disease Behind ‘Brain On Fire’

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Andrew Follett Energy and Science Reporter
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Doctors are now closer to understanding what causes a set of dangerous diseases made famous by the book-turned-film “Brain on Fire,” according to new brain imaging research from Henry Ford Hospital in Detroit.

The new research, obtained by The Daily Caller News Foundation, is already helping doctors identify and treat autoimmune encephalitis, which can trigger episodes of psychosis, memory impairment and seizures.

“Most of the clinical manifestations of this diseases relate to the fact that patients have antibodies produced that basically attack their brains,” Dr. Brendan Kelley of Henry Ford, who-co-authored the research, told TheDCNF.

“In this setting, white blood cells get confused and attack parts of the brain thinking they’re not normal,” Kelley said. “That causes these parts of the patient’s brain to not work correctly.”

Autoimmune encephalitis is a diverse group of neuro-psychiatric disorders that triggers an alteration of consciousness, including cognitive decline, seizures and abnormal movement. It was introduced to the public by a 2012 bestselling autobiography by New York Post journalist Susannah Cahalan that detailed her struggle with the disease. The book has been made into a new movie.

The disease belongs to a fairly new category that involves the central nervous system, and it is very difficult to diagnose since it looks similar to other illnesses. Even using medical imaging to diagnose the disease, which the study details, can be fairly difficult.

“It’s something relatively new [and] it’s not a diagnosis that would have been considered previously,” Kelley said. “The diagnosis is difficult to make if you’re not familiar with it, even if you use medical imaging.” Treating autoimmune encephalitis is also a challenge because the disease alters how the body’s immune system functions.

“The behavioral changes that we see can start out as subtle or not specific,” Kelley said. “Patients can become aggressive, delusional or confused. The best-documented cases are people who start out with a psychiatric diagnosis that gets progressively worse and eventually includes more severe features that requires transfer to the intensive care unit. They may start developing stroke like system, blindness or other issues that can’t be explained by a psychiatric diagnosis.”

If the condition is not diagnosed and treated in a timely fashion, patients can experience irreversible brain damage and a substantially reduced quality of life.

“There are clear guidelines how to diagnose and treat this illness,” Kelley said. “In my hospital system, we can move much faster than we did before because of this research.”

Despite difficulties in treating autoimmune encephalitis, patients can make full recoveries in some cases if it’s caught early.

“The treatment revolves around suppressing the immune response, but we can’t really do that in patients who might have an underlying infection,” Kelley said. “It’s really important that we’re confident in our diagnosis before we start treatment so that there aren’t complications from the treatment itself.”

And given the devastating impact of autoimmune encephalitis, a quick and accurate diagnosis is crucial.

“Patients can do quite well and have good recoveries, even going back to their own standard of living before it happened if we catch this early,” Kelley said. “If we catch it late, the patients may never recover however.”

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