1. Autoimmune Encephalitis
”A Disease of Madness”
Kristi Wrolstad, Tristan Buie-Collard
Department of Psychology, University of North Carolina-Asheville
Mistaken Identity
Many have mistakenly brought
their loved ones to get
exorcised believing that the
sudden erratic and sometimes
violent behavior was due to
demonic possession
Case Study #1
Patient 1 suffered from the following ailments and symptoms:
•Severe headaches
•Numbness in the mouth/on the face
•Numbness in the legs
•Mononucleosis
•High fever for 9 months
•Scoliosis
Answer: Five years ago, Patient 1 was misdiagnosed with MS. As of today, doctors still have not been able to deduce
what is wrong with her. Patient response:
“ Honestly, I haven't gotten a complete answer [as to what disease I suffer from]. The meds ruined years of my life.
They decided didn't have MS when I convinced them that I never had a real exacerbation and I really didn't have any
other symptoms of the disease. I suggested that it may have been brain damage due to the fever I had when I had
mono since the lesions they found on the MRI are in my frontal lobe. The neurologist agreed and basically sent me
on my way. I didn't really care at the time because I just wanted out of the situation. I think the cramping and
numbness I was experiencing may have been an issue related to my back, maybe a pinched nerve? Either way,
nothing has happened and it's been nearly 2 years since the diagnosis was reversed (fingers crossed). I work full-
time in a hospital and I am in Nursing school.”
Case Study #2
Patient 1 suffered from the following ailments and symptoms:
•Blurred Vision  Pink Eye Assumption Blind in one eye
•Daily headaches
•Fatigue
•Slight verbal communication impairment
•Poor long-term memory
Tonya was diagnosed with optic neuritis, a common symptom of multiple sclerosis. After two months of patience, and a
confirmed diagnosis of MS, she was told that she would be “walking with a cane in 10yrs and in a wheelchair in 20 if [she]
did not start treatment.” However, despite the recommendation from her neurologist, Tonya decided that the Rebif
shots (Interferon Beta 1a) were not the treatment for her, considering the dangerous side effects. She opted to take her
diagnosis into her own hands with chiropractor visits, exercise, a healthy diet, and a low stress life style. As advised by
her doctor, using medication to “suppress” MS is not the choice for everyone.
Treatment 1
•Natalizumab: Natalizumab is a monoclonal antibody that is used in patients with a relapsing
high disease activity of Multiple Sclerosis. The purpose of the drug is to prevent the attaching
and passing through of inflammatory immune cells to the blood brain barrier and the layers of
cells lining the intestines. Patients who have had 2 or more documented relapses of MS are
administered this antibody. The usage of this antibody assists in the reduction of MS symptoms,
the prevention of relapses, the prevention of vision loss, and the prevention of cognitive
decline. The results from the study Efficacy of Natalizumab in Multiple Sclerosis Patients with
High Disease Activity: a Danish Nationwide Study showed that of the 234 patients treated in this
experiment, 134 relapses occurred (a relapse rate of 0.68).
Treatment 2
Injection devices of interferon-beta-1a: Subcutaneous administration
of interferon-beta-1a (a drug produced by mammalian cells) was tested
on patients to measure treatment satisfaction based upon injection
devices being utilized. According to the study Patient Satisfaction with
an Injection Device for Multiple Sclerosis Treatment, “Patients’
subjective experience of how effective, tolerable, and easy a
medication is to use may affect their persistence with that medication.
“ Patients who use subcutaneous treatments will fail to continue
injecting their medication consistently, thus, it is essential to conduct
research to determine whether or not injection of MS treatment drugs
such as interferon-beta-1a are effective treatment plans. The research
conducted tests pain and instrument sensitivity—major factors in
determining whether patients will continue their treatment plans.
Results from this research showed significant improvements with the
new injection device (Rebeject II) in all MS Treatment Concerns
Questionnaire subscales.
Treatment 3
Cell Therapy: Stem cells from adipose tissue offers a sufficient treatment for patients with
Multiple Sclerosis. The implications of implementing adipose derived cells in MS patients sheds
potential on the treatment of inflammatory conditions. In a research study conducted, Non-
expanded Adipose Stromal Vascular Fraction Cell Therapy for Multiple Sclerosis, Minev and his
colleagues provided adipose-derived stem cells to 3 patients. Patient one, a 50-year-old man,
reported a loss of coordination, imbalance, and severe pain prior to being treated. However,
after being treatment, patient one reported significant improvements in coordination, energy,
and balance. Patient two, a sufferer of persistent seizures, reported significant improvements in
spasticity of his legs and arm. The last patient, a sufferer of MS for more than 15 years, reported
improved coordination and energy after stem cell infusion.
Conclusion
Medical treatment for multiple sclerosis is currently limited to treating symptoms. The
primary treatments, such as Interferon Beta 1a and Natalizumab, suppress inflammation of
the brain. We do not yet know the cause of demyelination in MS patients. Treatment can
increase quality of life for MS patients and slow the progression of degeneration, however,
there is no cure. Future research objectives aim toward preventing MS, reducing cognitive
damage from MS, and repairing existing demyelination.
Mission Hospital Medication
Treatment
•Interferon Beta 1a
Use: Suspected MS (30 mcg IM 1/week or 22 or 44 mcg
subcutaneously 3/week)
Relapsing-remitting MS (30 mcg IM 1/week or 8.8 mcg
subcutaneously 3/week for 2 weeks with a gradual increase)
•Interferon Beta 1b
Use: MRI consistent with MS w/ first clinical episode,
relapsing-remitting MS, progressive-relapsing, & secondary-progressive (Initial dose
of 0.0625 mg subcutaneously with gradual increase to .25 mg every other day)
~Interferons are proteins that are released in the body in response to pathogens. They enable
communication between cells to trigger the immune system, and are useful as an anti-inflammatory of
immune cells and the blood-brain barrier. However, the body will eventually form a tolerance, often
there are no seen effects, and is only used to reduce relapse rates and slow the progression of MS.
•Methylprednisolone
Use: Acute exacerbation (500 to 1000 mg IV for 3 to 5 days)
Optic neuritis (250 mg IV every 6 hrs for 3 days with
tapering schedule)
~Methylprednisolone is a synthetic corticosteroid, a chemical that modifies the immune system and
works as an anti-inflammatory in the central nervous system and the optic nerve.
•Natalizumab
Use: Relapsing-remitting MS that has failed to respond to other
therapies (300 mg IV 1 hour / 4 weeks)
~Natalizumab is an anti-body used to suppress inflammation, commonly used in conjunction with an
interferon,.
There are also treatment plans for dealing with these symptoms:
Acute pain, Musculoskeletal pain, Neuropathic pain, Fatigue, Increased muscle tone and
spasticity, Nocturnal spasms, Urge incontinence / Detrusor Hyperreflexia, Flaccid bladder,
Vertigo, Tremor, Ataxia & more
Mission Hospital Treatment
Options
1. Chemotherapy- shuts down the immune system to change the course of MS
2. Immunotherapy- prevents the immune system from attacking the body
3. Steroids- may shorten the time an episode of symptoms last
4. Medications- control and decrease MS symptoms
5. Rehabilitation programs- mental and physical exercises