Dr. Rachel Gelman delivered an excellent morning report presentation on encephalitis. It was a good exercise on clinical decision making and systematic workup for meningitis / encephalitis of any cause. The pt. was diagnosed with Anti-NMDA receptor encephalitis. The disease mainly affects females, and is characterized by psychiatric manifestation, seizures, dyskinesias and autonomic instability. It is also associated with ovarian teratomas in 50% of patients.
The book is Brain on Fire: My Month of Madness by Susannah Cahalan. It’s a nice weekend read (if you’re on an elective!) and tells the story from the patients’ perspective. It also adds a little twist by suggesting that Anti-NMDA receptor encephalitis is a possible explanation to what has been historically described as “demonic possessions”.