When 48-year-old Ryan Alto from California walked into the emergency room with what seemed like mild flu symptoms, no one—not even he—could have predicted how rapidly things would spiral. Within hours, he was hallucinating. Soon after, he lost consciousness. By the end of the day, Ryan had slipped into a coma. What doctors discovered next would upend everything his family knew about illness, mental health, and recovery.

He wasn’t battling a virus. He wasn’t having a psychiatric breakdown. Ryan had Anti-NMDA Receptor Encephalitis—a rare, autoimmune brain disorder so misunderstood it’s often mistaken for mental illness.

What is Brain on Fire Disease?

Anti-NMDA Receptor Encephalitis, sometimes referred to as “Brain on Fire” disease, is caused when the body's immune system mistakenly attacks NMDA receptors in the brain. These receptors play a key role in memory, cognition, and behavior. When they malfunction, it can look eerily similar to a psychiatric or neurological breakdown.

Symptoms of Brain on Fire Disease

Initially, patients often present with flu-like symptoms: mild fever, fatigue, headaches. But in a matter of days, things can shift dramatically—paranoia, hallucinations, speech problems, seizures, and even catatonia may emerge.

In Ryan’s case, these escalated quickly. He started speaking incoherently. He experienced delusions, then seizures, and within days, fell into a coma that lasted eight weeks. When he woke up, the world was unrecognizable. He couldn't stand, speak, or even identify familiar faces.

Anti-NMDA receptor encephalitis affects an estimated 1.5 people per million annually, but that number may be underreported due to frequent misdiagnosis. Its symptoms mimic schizophrenia, bipolar disorder, or severe anxiety, often delaying correct treatment.

Women, especially between ages 12 to 45, are disproportionately affected. In these cases, the condition is frequently associated with tumors, particularly ovarian teratomas, which trigger the immune response. For others, it can follow a herpes simplex infection—another key but underrecognized link.

A study published in Neurology found that nearly 27% of patients recovering from herpes simplex encephalitis went on to develop autoimmune encephalitis, with Anti-NMDAR accounting for the majority of those cases.

Can 'Brain on Fire Disease' Be Treated?

The key to managing this condition lies in quick recognition and aggressive early treatment. But diagnosis isn’t straightforward. Blood and cerebrospinal fluid tests are needed to detect the anti-NMDA antibodies, which can take time—time many patients don’t have.

That’s why most experts recommend beginning immunotherapy based on clinical suspicion, even before test results are back.

Treatment typically begins with high-dose steroids, intravenous immunoglobulin (IVIG), or plasmapheresis to suppress the immune attack. If a tumor is detected, surgical removal becomes urgent. In more stubborn or recurring cases, drugs like rituximab or cyclophosphamide are introduced for long-term immune modulation.

In Ryan’s case, immunotherapy began after his coma was induced to manage seizures and brain swelling. Since regaining consciousness, his recovery has been slow but steady. He remains disoriented and confused, sometimes mistaking objects or people for things they’re not—a stuffed toy, to him, is a living creature. He’s learning to move again, a process his family says may take up to a year or more.

One of the most challenging aspects of anti-NMDA receptor encephalitis is managing its psychiatric manifestations. Patients can swing between aggression, hallucinations, mutism, and catatonia—often within hours. That’s why psychiatric support is as crucial as neurological intervention.

Medications like benzodiazepines, valproic acid, and certain antipsychotics like quetiapine are commonly used to manage behavioral symptoms. But the challenge lies in balance: too much sedation can worsen neurological symptoms like abnormal movements or cognitive delays.

Doctors typically tailor medication regimens carefully, opting for sleep aids like trazodone or clonidine when needed and tapering off psychiatric drugs as neurological recovery improves.

How Treatment Helps Manage Seizures?

Seizures are common in anti-NMDA receptor encephalitis and often the first visible signs of a deeper problem. Most patients experience focal or generalized seizures, and while immunotherapy usually helps reduce them, anti-seizure medications are added to prevent complications.

Interestingly, sodium channel blockers tend to perform better than some commonly used medications like levetiracetam, which can worsen psychiatric symptoms. Most patients can eventually taper off anti-epileptics after two to three years of stability.

Can This Disease Come Back?

Unfortunately, yes. Relapses are a real possibility, even years after initial recovery. This underscores the need for long-term monitoring. Experts advise follow-ups with a neuroimmunologist, especially if the original trigger—like a tumor—was never identified.

If relapse occurs, doctors recommend treating it as aggressively as the first time: re-evaluation for tumors, renewed immunotherapy, and psychiatric support.

If you or someone you know starts showing sudden, unexplained changes in behavior—especially after a recent infection or illness—don’t dismiss it. Ask about autoimmune encephalitis. Because sometimes, what looks like a breakdown… is actually the brain crying out for help.

Delhi's air quality remained in "very poor" category, and the AQI stood at 342 at 8am, as per the Central Pollution Control Board. The 24-hour average AQI was logged at 412 under the "severe" category on Tuesday evening when Delhi's quality peaked to record the fourth severe air day in the month of December. With the air quality levels remaining continuously in the "very poor" category, Delhi's Chief Minister Rekha Gupta held a pollution review meet.

What Was Discussed In The Pollution Review Meet By Rekha Gupta?

A review meeting was held to discuss the rising air pollution levels in Delhi on Monday at the Delhi Secretariat. The meeting was attended by the officials from various departments, which also included the Public Works Department (PWD), Transport, Delhi Pollution Control Committee (DPCC), Environment, and others.

Post meeting, Delhi Environment Minister Manjinder Singh Sirsa said that the CM sought responses from multiple departments to discuss various aspects of pollution in the national capital. Sirsa also confirmed that a follow-up meeting will be scheduled on Thursday to continue the discussions on various steps that should be taken to bring down the levels of Delhi's AQI.

Rely On Public Transport - As A Solution To Delhi Pollution

On Sunday, a day before the meeting was held, Delhi's CM spoke on relying on public transport as a solution to Delhi's pollution. She said that the government aims to make the metro network "so comprehensive that people do not need to rely on private vehicles even for last-mile connectivity”.

Also Read: Delhi Is a Gas Chamber Where Nothing Comes In or Goes Out, Says Expert; Neighboring States Not to Blame for AQI

Delhi's Pollution Is Now A Public Health Risk

An analysis by the Global Burden of Disease (GBD) 2023 found that air pollution is city's single largest health risk. The deaths rose from 15,786 in 2018 to 17,188 in 2023.

Another study published in Scientific Reports, a five-year study titled Respiratory Deposition of Particulate Matter in Delhi: A Five-Year Assessment of Exposure Patterns and Health Risks tracked how particulate matter settles inside the respiratory system and found that men's exposure can be up to 1.4 times higher, especially while walking or commuting. The study noted that men on average spend more time outdoors while working, commuting, or walking in traffic-heavy areas. This leads to an increase in exposure.

A different study published in Frontiers in Public Health, explored the data of 2,96,078 women and girls between the age of 16 to 55 years in Taiwan and correlated it with the long-term air pollution data between 2000 and 2013. None of these women had any history of dysmenorrhea before the survey had began.

Read: Is Delhi's Toxic Air Making Your Period Cramps More Painful? Here's What Study Says

Furthermore, a study published in Nature Communication notes that after four hours of exposure to particulate matter, it was found that people's ability to perform routine tasks and interpret emotions were highly impacted.

If Delhi is able to cut its local pollution by 50 per cent, the pollution too could drop by 50 per cent. The emission should happen across the airshed. However, the focus should be for a long-term action on the source of emission and not short-term optics like cloud seeding, smog towers, water sprinkling or air purifiers.

In fact, as per a study published in Sustainability (MDPI), an open access journal, which mapped Delhi's air quality between 1990 to 2022 and found that transports emit around 10 to 30% of pollution, whereas agricultural residue burning, which is a seasonal source of pollution leads to less than 3% of pollution, whereas firecrackers, another seasonal source, leads to less than 1% of pollution.

Do you feel an awful soar in your throat? Have you noticed that anyone you speak to are also complaining of the same symptoms? All of them, and you, seem tired, have a sore throat and no energy for days and weeks to follow. This might be what people are called "mystery disease" or the "mystery throat virus". However, this is actually the adenovirus.

Most patients with bad throat, explain experts have adenovirus, which is a common virus that spreads throughout the year. However, unlike the flu and COVID, which now have their own prescribed medicines, adenovirus has none.

Read: This Mysterious New Virus Could Spread Faster Than Covid-19 And Flu

What Exactly Is Adenovirus?

Adenovirus is a virus that has more than 60 different strains, which is why it is able to cause a variety of symptoms. Adenovirus refers to a group of common viruses that usually trigger cold- or flu-like illness. It spreads easily because it is far more resilient than many other viruses. Ordinary soap, water, and standard disinfectants do not reliably destroy it, allowing it to persist in the environment. As a result, infections often cluster in places where people spend time close together, such as daycares and military barracks. The virus spreads through the respiratory tract, can be shed in stool, and can survive for some time on contaminated surfaces, according to the CDC.

The reason for its spread right now is due to the surge of flu cases in the southern hemisphere which has influenced the outbreaks in the northern hemisphere. Another reason is the lower flu vaccinate rates, which has now made a large number of population more vulnerable to infections, overall, including adenovirus.

What are The Symptoms Of Adenovirus And What Makes It Very Contagious?

While a lot of the symptoms mimics of those in flu or COVID, including shortness of breath, a sore throat and or a runny nose. However, there are certain unique symptoms of adenovirus that include:

• Diarrhea
• Pink Eye or conjunctivitis
• Ear infection or otitis media
• Swollen lymph nodes
• Pneumonia
• Stomach pain
• Nausea
• Vomiting

Other rare symptoms could also include impact on your bladder or nervous system. As viruses in your bladder can also cause urinary tract infections, and the same virus in your nervous system can cause condition that can affect your brain. These conditions also include encephalitis and meningitis.

Read: Unique Symptoms Of Mysterious Adenovirus And How Long Infection Now Last

What makes this virus unique is that it can spread through easily. Adenovirus is highly contagious. It can spread from one person to another through shaking hands, kissing, or even hugging. The virus could also spread through sneezing, coughing, and if by any other means respiratory droplets transfers to other person in air. It can also spread by touching contaminated surface, and you can get the virus by touching your eyes, nose, or mouths if you do not wash your hands.

The virus can also spread through stool of an infected person. For instance, you can be infected while changing your baby's diaper. It can also spread through unchlorinated water, and a person can be infected with the virus if he or she swims in a pool without adequate chlorine.

Adenoviruses are resistant to many common disinfectants. Therefore, they can remain infectious on surfaces for a long time.

When Should You See A Doctor?

If you are generally healthy, and feel a little down, but do not have shortness of breathe or a high fever, you are safe to go, with supportive care at home. However, pay close attention to those who are already on medical attention, or those who are immunocompromised, or are infants.

If you are sick, have a high fever, and experiencing shortness of breath, it is best to consult your doctor. However, do not show up to your doctor's office, call first.

Ben Sasse, former Senator, on Tuesday shared that he has been diagnosed with pancreatic cancer. His diagnosis came at Stage 4.

Is Ben Sasse's Cancer Terminal?

The former two-term senator, 53, revealed this in a social media or X, message: “This is a hard note to write, but since many of you have already sensed something, I’ll get straight to it: Last week I was diagnosed with metastasized, stage-four pancreatic cancer, and I am going to die.”

Also Read: 2 Dead, 21 Injured After Pennsylvania Nursing Home Catches Fire

Stage 4 cancers are terminal and his terminal diagnosis was "hard for someone wired to work and build, but harder still as a husband and a dad," he said.

Stage 4 cancers are terminal because the cancer has metastasized, which means it has spread from its original site or the primary tumor to distant organs and tissues. This makes it extremely difficult to cure with localized treatments like surgery or radiation.

However, the American Oncology Institute does note that stage 4 cancer always does not have to be terminal, especially with breakthrough treatment options like targeted therapy, immunotherapy, or precision medicine. There are now also advanced surgical techniques that use minimal invasion procedures.

Also Read: Ben Sasse Diagnosed With Stage 4 Pancreatic Cancer: What We Know About His Diagnosis

What Is The Chance Of Survival In Stage 4 Cancer?

According to the American Cancer Society, pancreatic cancer makes up about 3 percent of all cancers in the United States but accounts for roughly 8 percent of cancer-related deaths. Most patients are diagnosed at Stage 4, and the disease is widely regarded as largely incurable. Prostate cancer, by contrast, is the second most common cancer among men, and the majority of those diagnosed do not die from it. The five-year relative survival rate for non-metastasized prostate cancer is 97.9 percent, dropping to about 38 percent once it spreads. These figures highlight how early detection and effective treatment options make prostate cancer far more survivable than pancreatic cancer.

What Are The Treatment Options For Ben Sasse At Stage 4 Cancer?

While treatments including chemotherapy, radiation, and in rare situations surgery are available, stage-four pancreatic cancer is still considered largely incurable. The absence of effective early screening contributes to delayed diagnosis, and although a small number of patients, such as Ruth Bader Ginsburg, have lived longer following surgery, these cases are rare. Well-known individuals including Alex Trebek and Aretha Franklin also battled the disease, which remains one of the deadliest cancers in the United States.

Former senator and former University of Florida president Ben Sasse announced on Tuesday, Dec. 23, that he has been diagnosed with terminal stage 4 cancer, as per CNN News.

In the deeply personal message, the former Republican lawmaker from Nebraska described the diagnosis as a “death sentence,” while expressing appreciation for the steady support of his family and close friends.

“I’m fortunate to have incredible siblings and half a dozen friends who are truly like brothers to me. As one of them said, ‘Yes, you’re on the clock, but all of us are.’ Death is a cruel thief, and none of us escape it,” he added.