“I know that it wasn’t me, and I couldn’t control it,” she said quietly. “But it was ... it was a little scary.”
These words highlighted Kiera Echols' reaction on watching a YouTube video based on her case that her physician, Dr. Chris Kobet has entered in the 2010 Neuro Film Festival sponsored by the American Academy of Neurology Foundation. Echols, a 22-year old former honour student training to be a medical technician, began developing headaches, body aches, and neck stiffness last November that were initially attributed to meningitis. As her condition worsened, she went to stay with her parents in Springfield, Ohio since her husband, was away on basic training in the U.S. Air Force. Kiera Echols began developing intense neurological symptoms including blackouts as well as bizarre delusions. During one episode, she screamed for an hour that she was in labour. On November 16, her parents took her to a local hospital where they were advised to have her committed to a psychiatric hospital. They refused to accept this diagnosis.
After an odyssey of consultations, Kiera Echols came to the attention of University of Cincinnati neurologist, Dr. Chris Kobet who diagnosed her with anti-NMDA receptor encephalitis. First identified in 2007 by Josef Dalmau at the University of Pennsylvania, this particular form of autoimmune disorder was apparently triggered by a benign tumour on her ovaries (a teratoma). In producing antibodies to attack the tumour, her immune system also attacked her central nervous system resulting in the bizarre psychiatric symptoms that she experienced. As only the third case of anti-NMDA receptor encephalitis reported to date, Kiera was fortunate in coming under the care of Dr. Kobet who had dealt with similar cases in the past. Although a reliable test for the condition is not yet available, tissue samples were sent off to Dr. Dalmau for a definite diagnosis to be made. Once the teratoma was located, it was removed in a surgical procedure on December 23.
Since that time, Kiera Echols has made a remarkable recovery, assisted by her parents and her husband who is caring for her full-time. There have been no new psychotic episodes since January and she is hoping to resume her normal life in time. In making her decision to go public with her story, Kiera Echols has expressed the hope that her case will generate greater awareness of the devastating impact that anti-NMDA receptor encephalitis can have and the possibility that some women may have been misdiagnosed and unintentionally institutionalized in the past.