Possession

This is one of those stories that come out of medicine every once in a while that show how little we understand our bodies:

Susannah Cahalan was a young New York Post reporter when she started to forget assignments. She became fixated on the idea that her home was infested with bedbugs. Paranoid and irrational, she laughed and cried inappropriately, moods rocketing from euphoria to intense sadness.

She thought it must be stress, or the flu. One doctor told her she had mono. Her parents suspected she was on the verge of a nervous breakdown. Then she, too, had a seizure.

The women’s slow unraveling could have been the beginning of a psychotic break, followed by a lifetime of hospitalization and medication.

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 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.

A long time ago this might have been ascribed to possession, ten years ago it might have been thought to be schizophrenia or some other mental illness. The article speculates that some people who are being treated for schizophrenia might instead have this disease. This is the kind of paradigm shift that happens in medicine at times, the cause and treatment of ulcers is one that I think of. They’re going to start testing with an initial episode of a psychotic episode, it would be great if they found a large percent of these are caused by this disease (they don’t expect this to be true, though).

1 Comment (+add yours?)

  1. klloyd9
    May 27, 2013 @ 21:23:44

    Very interesting. Psychology, a fascinating subject.
    You mentioned drugs ketamine and PCP block those receptors and cause schizophrenic symptoms? If that is the case why would they prescribe it to this patient? It makes you wonder whether anti-NMDA receptor encephalitis is triggered by stress.

    Reply

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