Does Trump Have Dementia or is He A Genius?

[mahatmakanejeeves]

24. That's not always dispositive. I just stumbled across this in today's news.

Doctors thought she was psychotic, but her body was attacking her brain

By Michael Nedelman, CNN
Updated 6:18 PM ET, Tue August 29, 2017

....
Cahalan's story sounded familiar to the Gavigans. She had become paranoid and exhibited odd behavior, just like Emily. She became convinced that she had bed bugs, and she could feel them on her left hand and face, according to neurologist Dr. Souhel Najjar, who treated Cahalan. ... But Najjar had a hunch that Cahalan might have a neurological problem, not a purely psychiatric one. ... So he asked asked Cahalan to draw a clock, and she drew all the numbers bunched up on the right side. This alone couldn't make a diagnosis, but it clued doctors in that something could be misfiring on the right side of her brain. ... That something, it turned out, could be treated.

The wrong target

The key to making the right diagnosis is a simple test on the blood or spinal fluid, Najjar said. You just have to know what you're looking for: a type of antibody. ... To fight off disease, the immune system makes antibodies, Y-shaped proteins that attack foreign invaders like bacteria or viruses. But sometimes, those proteins can attack our own bodies. This is known as autoimmune disease. ... In Cahalan's case, those antibodies were directed against a receptor in her brain: the NMDA receptor, which plays a role in how brain cells communicate with each other. The receptor takes part in the brain's normal functioning, from memory to breathing.

The disease was given a name in 2007: anti-NMDA receptor encephalitis, or NMDARE for short. Had Cahalan had the disease a few years prior, there would have been no diagnosis to give her. ... "The disease is definitely not new," said Dr. Josep Dalmau, a neurologist at the University of Pennsylvania who is credited with discovering the disease.

Many patients have been misdiagnosed with schizophrenia and other mental illnesses, Dalmau said. Some have been admitted to psychiatric units, where they were given medications, electroconvulsive therapies and other treatments that probably made their symptoms worse, he added. ... There are over 15 known types of autoimmune encephalitis, according to the Autoimmune Encephalitis Alliance. Meaning the immune system can attack other brain receptors, too.