This article is an excerpt from the Shortform summary of "Brain On Fire" by Susannah Cahalan. Shortform has the world's best summaries of books you should be reading.
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What are the autoimmune encephalitis causes that are most common? Is autoimmune encephalitis hereditary?
Autoimmune encephalitis causes are not fully understood. There are some correlations that have been identified, but no specific causes are confirmed.
Read more about the autoimmune encephalitis causes that have been considered.
What Causes Autoimmune Encephalitis?
Cells receive signals through receptors. NMDA receptors excite cells that participate in learning, memory, higher functions, and personality. In 2007, Dr. Dalmau identified a new disease that would come to be called anti-NMDA-receptor encephalitis. This condition is caused when antibodies disable NMDA receptors. Experiments indicate that a 40 percent loss of NMDA receptors results in psychosis. A 70 percent loss results in catatonia. An absence of any working NMDA receptors results in death.
Najjar suggests that Susannah might have viral encephalitis. Without seeing her, he prescribes an antiviral drug and recommends testing Susannah for viral encephalitis, caused by a herpes virus. Again, all the tests come back negative. So, what causes autoimmune encephalitis?
Drs. Russo and Najjar send Susannah’s cerebrospinal fluid to Dr. Dalmau, the neuro-oncologist who had conducted the study on four young women that Dr. Najjar remembered when he saw Susannah’s clock test. Like Susannah, the four women in Dalmau’s study had a high white blood cell count and suffered from hallucinations, confusion, and memory deficits. They also had two other things in common: an ovarian tumor and antibodies that disable a critical apparatus in the brain called the NMDA receptor. By the time Susannah is struck by the disease, Dr. Dalmau has developed two tests that allow for a swift and accurate diagnosis.
Dalmau confirms a diagnosis of anti-NMDA-receptor encephalitis, a disease caused by Susannah’s antibodies attacking her brain. Najjar puts Susannah on an aggressive treatment plan.
Scientists currently have little understanding of what triggers anti-NMDA-receptor autoimmune encephalitis. In people with teratomas, the tumor may set off an autoimmune attack. In the absence of teratoma, causes are unknown. Is autoimmune encephalitis hereditary? Maybe. Causes may also be environmental. Because there is so little understanding of what causes the disease, researchers focus on diagnosis and treatment rather than prevention.
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Here's what you'll find in our full Brain On Fire summary :
- How a high-functioning reporter became virtually disabled within a matter of weeks
- How the author Cahalan recovered through a lengthy process and pieced together what happened to her
- How Cahalan's sickness reveals the many failures of the US healthcare system