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What was the disease in Brain on Fire? How did the disease in Brain on Fire change Susannah’s behavior?

Start studying Brain on Fire - Susannah Cahalan. Learn vocabulary, terms, and more with flashcards, games, and other study tools. 'Brain on Fire: My Month of Madness' should be required reading for everyone in the health care profession- especially neurologists. This past April, 2017, my 18 year old granddaughter, Alysa, after having had seizures, spent 2 weeks in the hospital; MRI's. Brain on Fire (2012) is a memoir by New York Post writer Susannah Cahalan that details her struggle with a rare autoimmune disease, anti-NMDA-receptor autoimmune encephalitis. Cahalan recollects the journey through illness that took her from a normal, 24-year-old journalist to a misdiagnosed psychotic patient, and back again.

The disease in Brain on Fire is anti-NMDA-receptor encephalitis. It is a rare disease that was difficult to diagnose.

Read more about Susannah Cahalan and her journey to diagnose the disease in Brain on Fire.

Onset of the Disease in Brain on Fire

At 24 years old, Susannah Cahalan is an ambitious, dedicated reporter for the New YorkPost. She’s admired by her colleagues and respected by her editors. Like most 24-year-olds, she thinks nothing can go wrong with her vibrant, happy life.

Uncharacteristic Behavior

During the height of the Manhattan bedbug scare in 2009, Susannah finds two red dots on her arm. She’s convinced her apartment is infested, even though an exterminator says otherwise. Susannah doesn’t know she’s suffering from Ekbom syndrome, an obsession with bugs that can signal the onset of psychosis. This was the start of Susannah’s brain on fire symptoms.

A few days later, Susannah wakes up contentedly, alone in her boyfriend’s bed; Stephen’s a musician, and he’s already at rehearsal. They’ve only been dating a short time, but their relationship is trusting and comfortable.Suddenly Susannah is hit by another thought that’s completely out of character—an overwhelming compulsion to read his emails. Her paranoia was part of the brain on fire symptoms. She opens his computer and combs through his correspondence until she finds old messages from his ex. She digs through his dresser until she finds letters from ex-girlfriends.

Suddenly she sees herself in the mirror. The image disgusts her. She’s overcome by nausea and a migraine. Her left hand begins to tingle, then goes numb.

The tingling lasts for days, but Susannah is more worried by her uncharacteristic behavior than by her physical symptoms. She ignores the numbness until it moves down to her toes. She contacts her doctor, who refers her to Dr. Bailey, a famous neurologist.

Ineffectual Diagnoses

Bailey conducts a routine neurological exam and declares everything is normal. He prescribes an MRI, which comes back normal. Bailey suggests Susannah has a virus, possibly mono.She’s relieved to have a diagnosis. Her brain on fire symptoms were all over the place, so a virus was possible.

Susannah returns to work. When she pitches two more stories and they’re both rejected, she blames her poor performance on mono and takes another day off. Her doctor calls to tell her she doesn’t have mono after all.

That night marks a turning point. Stephen cooks Susannah an elaborate meal, but she can’t eat it. Her thoughts run wild. She paces and chain-smokes. She’s consumed by the desire to escape. She tries watching a TV show, then everything goes hazy. Susannah has her first seizure.

The Seizures Take Over

Susannah awakes in the emergency room. After conducting a series of tests, the hospital discharges her over Stephen’s objections. The following morning her mom and stepfather bring her to their home in New Jersey. Settling in, Susannah tries to work on an article for the Post, but she’s unable to write. A psychiatrist in their circle suggests that Susannah has bipolar disorder and is having a manic episode. Once again, Susannah is thrilled to get a diagnosis, however dire it is.

Susannah returns to the city under her father’s care. All’s well at first, but her paranoia soon returns. “They’re kidnapping me!” Susannah screams, convinced she isn’t safe with her father.

Convinced her father is going to kill her, Susannah runs to the front door of the brownstone and bangs her fists against the door, screaming, “Let me out!” When she hears her father coming, she locks herself in the bathroom.

That night Susannah’s parents agree that she must be admitted to a hospital, as long as it’s not a psych ward. Though Bailey is still convinced Susannah just drinks too much, he secures her a room at NYU Langone’s Advanced Monitoring Unit, with 24-hour EEG monitoring. As soon as they arrive at the hospital, Susannah has a seizure.

From here on in, Susannah has no memories of the next month. There will be no glimmers of the “I” she had been for twenty-four years. She is unable to access her rational consciousness, and the break with her self is complete.

Susannah Callahan Brain On Fire

Susannah Brain On Fire

As Susannah continues to deteriorate physically, her psychosis seems to recede. She spends most of her time staring into space. On her fifth day in the hospital, she’s given a spinal tap.

Susannah’s spinal tap shows an elevated number of white blood cells—usually a sign of infection or inflammation, indicating that Susannah’s problem is physiological rather than emotional in nature. The news finally gives Susannah’s mom a clue she can comprehend.

Diagnosing the Disease in Brain on Fire

Susannah’s team runs autoimmune tests and bloodwork. The tests come back negative. Similarly, her MRIs and CT scans are clean. Susannah’s doctors begin to wonder whether they’ll actually be able to figure out the disease in Brain on Fire.

Dr. Siegel, the world-famous neurologist, quits Susannah’s team. Unbeknownst to Susannah’s family, he asks Dr. Souhel Najjar to take on Susannah’s case. Najjar has a track record of diagnosing a number of mysterious diseases. Based on Siegel’s expert summary, Najjar suggests that Susannah might have viral encephalitis. He prescribes a second spinal tap and an antiviral drug, and tests Susanah for viral encephalitis. All the tests come back negative.

Brain On Fire By Susannah Cahalan Free Pdf

Najjar performs a number of tests and concludes that Susannah is “hellishly catatonic.” Then he has an idea: the clock test! He hands Susannah a sheet of paper and asks her to draw a clock. After numerous attempts, Susannah shows her picture to Najjar: She’s squished all the numbers into the right side of the circle. Najjar claps his hands, ecstatic. He understands that this is concrete evidence that the right side of Susannah’s brain is inflamed. When the right hemisphere is impaired, the patient will not “see” on the left side.

Suddenly Dr. Najjar has a flash of insight: what if Susannah’s inflammation is an autoimmune reaction? He recalls a paper describing four young women stricken by a rare autoimmune disease. Could Susannah have the same condition? He can only answer these questions by removing a tiny portion of Susannah’s brain for study.

Najjar sends Susannah’s cerebrospinal fluid to Dr. Dalmau, the neuro-oncologist who studied the four young women with a rare autoimmune disease. 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 to treat the disease in Brain on Fire.

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Like what you just read? Read the rest of the world's best summary of Susannah Cahalan's 'Brain On Fire' at Shortform.

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

Netflix's newest original film might be the most terrifying it's ever made, and it's not even a horror movie. Brain on Fire is a medical mystery drama starring Chlöe Grace Moretz, and it's about the very real and extremely rare disorder that struck journalist Susannah Cahalan when she was just 24. The illness depicted on the film is truly the stuff nightmares are made of, but Cahalan made it through and is alive today. So where is the real Susannah from Brain on Fire now, and is she still feeling the effects of her horrific ordeal?

When Cahalan was struck by her illness in 2009, she was one year into her job as a New York Post reporter. Today, nearly a decade later, Cahalan still lives in New York and still works for the Post, having published her most recent article for the paper on June 16, writing about her experience of seeing a harrowing time in her life turned into a movie. But she wasn't just returning to the paper to address her past; she's been consistently writing articles for the Post for years. Just a week earlier, she wrote a piece on Maine lobsters, and her author page on the Post's website shows scores of articles she's written. It's great to see that Cahalan's ordeal didn't end up adversely affecting her career, but it very well could have.

Cahalan suffered from an incredibly rare anti-immune disorder known as anti-NMDA receptor encephalitis. The disease most commonly affects women in their childbearing years, like Cahalan, and is four times more likely to occur in women than in men, according to the Anti-NMDA Foundation. The illness is caused when a person's antibodies, which are produced by the immune system to fight infections, begin attacking the NMDA receptors in the brain. These receptors are responsible for much of the brain's activity, including memory, cognitive function, perception of reality, and even autonomic functions like breathing. It's unknown why these NMDA attacking antibodies are produced, but if left untreated, the disease is fatal. If caught early, however, the condition is highly treatable, which explains why Cahalan is perfectly healthy today.

As for the symptoms experienced by Cahalan, they're quite terrifying, and she can't even remember most of what happened to her due to the nature of her illness. It began with relatively minor symptoms: sensitivity to light and numbness on the left side of her body. Then she broke down crying for no reason at work, and began to worry that something was wrong, according to her own 2009 recounting of the episode in the Post. After seeing a doctor and getting no answers, she had a seizure, which prompted more doctor visits. She then became paranoid and delusional, believing her doctors were conspiring against her and that people on TV were talking about her. She stopped eating, stopped sleeping, and had hallucinations, including believing that her father murdered her stepmother, according to the Post. After being admitted to a hospital, she tried to escape and assaulted her nurses.

After a number of false diagnoses, including that she was bipolar or suffering from alcohol withdrawal, Cahalan finally received the correct diagnosis from Dr. Souhel Najjar. He asked her to draw a clock on a piece of paper, and when she did, she put all 12 of the numbers on the right side of the clock face, leaving the left side blank, according to NPR. This informed Najjar that the right side of her brain was inflamed, since it controls the left side of the body. He described the condition as her brain being on fire, which Cahalan later used as the title for her memoir about the ordeal that she published in 2012, Brain on Fire: My Month of Madness.

Today, Cahalan is healthy, though somewhat haunted by what happened to her. She can be considered one of the lucky ones, though. According to the Post, Najjar estimates that 90 percent of anti-NMDA receptor encephalitis cases go undiagnosed, meaning those patients will ultimately be killed by their bodies attacking their own brains. It's a horrifying way to go, but thankfully for Cahalan, she lived to help spread the word about this terrifying disorder so more people can hopefully receive treatment in time.