A new category of autoimmune diseases impacting the brain is prompting psychiatrists to reconsider certain diagnoses. Dr. Chris Hahn, a neurologist at the University of Calgary’s Cumming School of Medicine, highlights that autoimmune encephalitis, though uncommon, can manifest with psychiatric symptoms, leading to potential misdiagnosis of a mental disorder.
Nora Scott from High River, Alberta, experienced a medical journey starting in 2017 when she began facing sleep difficulties and persistent mental restlessness. This resulted in her taking a hiatus from work and becoming fixated on house cleaning, which raised concerns for her partner, Chris Johnson.
Scott’s behavior further deviated with extravagant spending and trip planning, resembling patterns observed in individuals with mental illness-induced psychosis. After being admitted to South Health Campus hospital and diagnosed with bipolar disorder, it took another four years and a subsequent hospitalization for her to be correctly identified with anti-NMDA receptor encephalitis, a rare autoimmune condition.
Autoimmune diseases involve the immune system attacking the body internally, affecting the brain in cases of autoimmune encephalitis. Such conditions can mimic mental disorders by targeting mood and perception areas. Despite the potential fatality of untreated anti-NMDA receptor encephalitis, some cases can go into remission, misleading clinicians and reinforcing psychiatric misdiagnoses in patients on mood-stabilizing medications.
Dr. Jadah Johnson’s persistence in reconsidering Scott’s diagnosis during her second hospitalization in 2021 led to the conclusive identification of anti-NMDA receptor encephalitis. National guidelines developed by Dr. Hahn aim to aid in the recognition of autoimmune encephalitis cases, emphasizing the rarity of misdiagnosing mental illnesses when autoimmune encephalitis is the underlying cause of psychosis.
Dr. Jai Shah from McGill University notes the evolving understanding of autoimmune origins of psychosis, emphasizing the need to avoid stigmatizing mental health conditions. He highlights the treatability of autoimmune encephalitis and the management potential of mental illnesses for individuals to lead fulfilling lives.
Following her correct diagnosis, Nora Scott and Dr. Jadah Johnson connected for the first time, affirming the critical role of timely and accurate medical interventions in patients’ well-being and recovery.