Essay: Anti-NMDA Encephalitis

While reading the first part of Susannah’s memoir, I thought that she did a great job at illustrating the progression of her symptoms and their effect on her life and relationships. One part of her experience that stood out to me was way some of the doctors and technicians handled her diagnostic process. On one hand, I did understand the challenge the doctors faced in attempting to diagnose Susannah’s symptoms despite her initial test results coming out to be normal. After we discussed the symptoms of Anti-NMDA Encephalitis, I developed even more of an understanding of the challenge they faced, given that the disease is newly discovered, not well understood, and the symptoms could be attributed to various causes
 
Despite learning this, I still feel frustrated that they were so adamant on attributing her symptoms to psychogenic and environmental, causes. From her first visit with her doctor, I felt as though many of the health professionals that assessed Susannah were too quick to dismiss her symptoms to her lifestyle. I think my frustration stems from the similarities I found between myself and Susannah’s. She was a busy, often stressed out woman, close to my age at the onset of her symptoms, who had been relatively healthy for most of her life. I could easily imagine myself in her position, and I empathized with Susannah and her family as they tried to get the answers they desperately needed.

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… discussing the effect of gender bias on diagnoses. Chiaramonte & Friend (2006) developed two studies to test whether a patient’s gender and the context that their symptoms were presented in (e.g. stress) would affect their diagnosis of coronary heart disease (CHD) and/or referral to a cardiologist. They presented medical students with a patient’s report that included their general information, typical CHD symptoms, and a note on the patient’s disposition at the time of assessment. The patient’s gender and stress symptoms were manipulated across variables. Then, the participants were asked to complete a questionnaire about their agreement with statements regarding the patient (e.g., “the patient is suffering from CHD”), followed by the Attitudes Toward Women Scale.

What surprised me most about their findings was that female patients received significantly lower diagnoses and referrals in comparison with male patients only when they were assessed in the stress context. In addition to this, when presented with stress, the origin of symptoms in the female patients was more likely to be interpreted as psychogenic. Chiaramonte & Friend (2006) argued that because .

In Susannah’s case, the doctors assessing her were aware of her career, and consequently the stressors that would come with it. These findings are particularly scary because patients just like Susannah could go misdiagnosed or without the proper care due to this underlying bias, which could lead to a dangerous outcome.

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Goldberg, Neufeld, Auriel, and Gandelmann-Marton (2013) explored the controversy regarding hospitalizing patients that appear to be otherwise healthy after their first unprovoked seizure. They reviewed past medical records of patients admitted to medical centers after experiencing unprovoked seizures without prior history —just as Susannah had experienced— in an attempt to determine the benefit of admitting these patients to a neurology department in order to assess potential causes and risk factors for seizure recurrence.

first violent seizure, According to the American College of Emergency Physicians, it is recommended that a patient that has experienced a first, unprovoked seizure can be discharged from the emergency room, provided that follow-up is available, if the patient “is aged [40 years or younger], has regained baseline mental status, has a normal head CT scan, and no neurological deficits as well as no comorbidities” (Goldberg et al., 2013). In Susannah’s case, she

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Notwithstanding this recommendation, the authors still maintained that conducting an EEG examination is the greatest advantage of hospital admission, as the probability of recording abnormal neural discharges is greatest “within 48 hours following the first seizure”.. … 180 (Kolb & Whishaw, 2015). Perhaps if Susannah was admitted following her first seizure, there would be a greater possibility that… If I were in Susannah’s position, I would hope that all possibilities were explored in depth before dismissing my symptoms as ‘all in my head’.

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Essay Sauce, Anti-NMDA Encephalitis. Available from:<http://www.essaysauce.com/health-essays/anti-nmda-encephalitis/> [Accessed 19-09-18].