Disease presentation and misdiagnoses Cahalan's disease manifested in 2009 when she was 24 years old. It began with sensory issues, which she later described in her article "My Mysterious Lost Month of Madness" as experiencing the world “brighter, louder, more painful.” She also began experiencing numbness in the whole left side of her body, and paranoid hallucinations of
bed bug bites. Concerned by the numbness, Cahalan sought out a neurologist who ran multiple inconclusive tests, including two normal MRIs. Cahalan began experiencing severe
insomnia and continued behavioral abnormalities. One night at her boyfriend's apartment, she had a
grand mal seizure and woke up in St. Luke's Hospital. Cahalan describes the hospital neurologist as dismissive, and she received her first of multiple misdiagnoses: alcohol withdrawal. Psychiatrists also misdiagnosed her with
schizophrenia and
bipolar I disorder. Cahalan was released from the hospital, and as her disease worsened, she had another grand mal seizure.
Hospital stay After her second seizure, Cahalan's parents took her to the hospital for an EEG and demanded that she not be taken to a psychiatric floor. Unlike many anti-NMDA cases, Cahalan was never admitted to a psychiatric ward. While at the hospital, Cahalan had her third seizure and was immediately placed on the epilepsy floor of New York University's Medical Center. Her hallucinations and delusions soared during the month she spent in the hospital. Cahalan had two
lumbar puncture procedures that revealed high white blood cell counts. Because high white blood cells count signify brain swelling, the case was officially passed to neuro-pathologist and epileptologist
Dr. Souhel Najjar at NYU medical center.
Diagnosis (anti-NMDA receptor encephalitis) Dr. Najjar had Cahalan perform a “clock test", which involves the patient drawing the face of a clock. When Cahalan drew her clock, she was only able to recreate half of it, indicating injury to one side of her brain. After a brain biopsy, it was concluded that Cahalan's issue was not psychiatric, but the result of anti-NMDA encephalitis, a brain-inflammation disease with an unknown cause. She was only the 217th person diagnosed with this illness.
Treatment and recovery In order to treat her disease, she was given an assortment of different steroids, infusions, and plasmapheresis. She made a full recovery without suffering long-term brain damage. == Film adaptation ==