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Brain On Fire: My Month of Madness is an autobiography by Susannah Cahalan. WARNING: although there is a happy ending, this is pretty rough reading. She was afflicted with NMDA receptor antibody encephalitis. This condition has likely been around for a long time, but was first described scientifically in 2007:  Dalmau, Josep; Gleichman, Amy J; Hughes, Ethan G; Rossi, Jeffrey E; Peng, Xiaoyu; Lai, Meizan; Dessain, Scott K; Rosenfeld, Myrna R; Balice-Gordon, Rita; Lynch, David R (2008). “Anti-NMDA-receptor encephalitis: Case series and analysis of the effects of antibodies”The Lancet Neurology7 (12): 1091–8. doi:10.1016/S1474-4422(08)70224-2PMC 2607118Freely accessiblePMID 18851928.

NMDA is an abbreviation for N-Methyl-D-aspartic acid. The commonly occurring and absolutely necessary amino acid glutamate works to send signals between nerve cells, especially in the brain. Under normal conditions glutamate plays an important role in learning and memory. But abnormally high concentrations of  glutamate can lead to overexcitation of the receiving nerve cell. Or the receptors for glutamate on the receiving nerve cell can be oversensitive, such that less glutamate is needed to excite the nerve.  This overexcitation can lead to effects that can cause cell damage and/or death. Certain glutamate receptors in the nerve cells of patients with Huntington’s Disease tend to be oversensitive.

What Susannah Cahalan had was somewhat similar in that her own immune system attacked her brain.

symptoms described in the next blog