Man Walks Into ER Feeling Unwell, Hours Later Starts Hallucinating—Now He’s Battling A Rare Disorder That Mimics Mental Illness

Updated Jul 8, 2025 | 05:00 PM IST

SummaryA California man was diagnosed with Anti-NMDA receptor encephalitis, a rare autoimmune brain disorder often mistaken for mental illness, after sudden hallucinations and seizures left him in a coma.
Man Walks Into ER Feeling Unwell, Hours Later Starts Hallucinating—Now He’s Battling A Rare Disorder That Mimics Mental Illness

Credits: Health and me

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.

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Scientists Find Protein Inside The Body That Reverses Brain Aging

Updated Mar 1, 2026 | 12:51 PM IST

SummaryCyclin D-binding myb-like transcription factor 1 or DMTF1a key protein in the brain can help to regenerate neural stem cells and improve aging-associated memory decline. NUS scientists found that this protein's levels are repressed in the “aged” neural stem cells
Scientists Find Protein Inside The Body That Reverses Brain Aging

Credit: Canva

Researchers at the National University of Singapore (NUS Medicine) have found a key protein in the brain which can help to regenerate neural stem cells and improve aging-associated memory decline.

Known as cyclin D-binding myb-like transcription factor 1 or DMTF1, the scientists found that this protein's levels are repressed in the “aged” neural stem cells and that restoring it is sufficient to restore the regeneration capabilities of such neural stem cells.

Assistant Professor Ong Sek Tong Derrick explained: "Impaired neural stem cell regeneration has long been associated with neurological ageing. Inadequate neural stem cell regeneration inhibits the formation of new cells needed to support learning and memory functions.

"While studies have found that defective neural stem cell regeneration can be partially restored, its underlying mechanisms remain poorly understood. Understanding the mechanisms for neural stem cell regeneration provides a stronger foundation for studying age-related cognitive decline."

How Does DMTF1 Protect Against Memory Decline And Dementia?

To understand how DMTF1 works, researchers looked at telomeres — the protective DNA caps at the ends of chromosomes. As we age and our cells divide, telomeres naturally become shorter. When they get too short, cells stop dividing and trigger inflammation. Due to this phenomenon, telomeres are often seen as a biological clock that cannot be reversed.

But DMTF1 seems to bypass this limit by helping neural stem cells to keep multiplying, even during brain aging. It does this by switching on helper genes that promote cell growth through a process called chromatin remodeling.

Importantly, this process can restore the growth of stem cells that had already been damaged by telomere shortening, showing that the effects of aging may not always be permanent.

The researchers plan to further explore if elevating DMTF1 expression can regenerate neural stem cell numbers as well as improve learning and memory under the conditions of telomere shortening and natural ageing, without increasing the risk of brain tumours.

What Is Alzheimer’s Disease?

Alzheimer's disease is one of the most common forms of dementia and mostly affects adults over the age of 65.

About 8.8 million Indians aged 60 and above are estimated to be living with Alzheimer's disease. Over seven million people in the US 65 and older live with the condition and over 100,00 die from it annually.

Alzheimer's disease is believed to be caused by the development of toxic amyloid and beta proteins in the brain, which can accumulate in the brain and damage cells responsible for memory.

Amyloid protein molecules stick together in brain cells, forming clumps called plaques. At the same time, tau proteins twist together in fiber-like strands called tangles. The plaques and tangles block the brain's neurons from sending electrical and chemical signals back and forth.

Over time, this disruption causes permanent damage in the brain that leads to Alzheimer's disease and dementia, causing patients to lose their ability to speak, care for themselves or even respond to the world around them.

While there is no clear cause of Alzheimer's disease, experts believe it can develop due to genetic mutations and lifestyle choices, such as physical inactivity, unhealthy diet and social isolation.

Early symptoms of Alzheimer's disease include forgetting recent events or conversations. Over time, Alzheimer's disease leads to serious memory loss and affects a person's ability to do everyday tasks.

There is no cure for this progressive brain disorder and in advanced stages, loss of brain function can cause dehydration, poor nutrition or infection. These complications can result in death.

Can You Detect Alzheimer's Early On?

The US Food and Drug Administration has approved the use of a blood test which can help diagnose Alzheimer’s disease in adults aged 55 and above.

The blood test, known as Lumipulse, can detect amyloid plaques associated with Alzheimer’s disease and has proven to be a “less invasive option” that “reduces reliance on PET scans and increases diagnosis accessibility.”

FDA Commissioner Martin A. Makary said of the landmark decision, "Alzheimer’s disease impacts too many people, more than breast cancer and prostate cancer combined.

"Knowing that 10 percent of people aged 65 and older have Alzheimer's, and that by 2050 that number is expected to double, I am hopeful that new medical products such as this one will help patients."

It remains unclear when this test will be available for commercial use across the world.

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The Difference Between Ozempic And Mounjaro And Which Weight Loss Drug Is More Effective

Updated Mar 1, 2026 | 06:00 AM IST

SummaryIn a podcast, Dr Ambrish Mithal explained that while both Ozempic and Mounjaro aid weight loss, Mounjaro combines GLP-1 and GIP, potentially offering about 10 percent greater weight reduction, though neither is FDA-approved solely for weight loss.
The Difference Between Ozempic And Mounjaro And Which Weight Loss Drug Is More Effective

Credits: Canva

Dr Ambrish Mithal, endocrinologist in a podcast with Ranveer Allahbadia, highlighted the difference between the popular weight loss drug Ozempic and Mounjaro. Dr Mithal said that a person can lose around 10 kgs in four to six months. When Allahbadia asked Dr Mithal if there is any difference. To this, Dr Mithal said that while Ozempic is a GLP-1 drug, Mounjaro is a combination of GLP-1 and GIP. In simpler language, if one has to compare the two for only weight loss, Mounjaro can outweigh Ozempic by roughly 10 per cent.

What Is The Difference Between Ozempic and Mounjaro?

While both drugs are approved by FDA and requires prescription, and doses increases over time to a maintenance dose, experiences shortages, not FDA-approved for weight loss.

Although several studies suggest that Mounjaro may lead to greater weight loss than Ozempic, it is not currently approved by the U.S. Food and Drug Administration specifically for weight loss. That said, doctors may prescribe both Mounjaro and Ozempic off-label to support weight management in certain patients.

A real-world comparative effectiveness study by Truveta Research examined the active ingredients in both drugs among overweight and obese adults. The findings showed that tirzepatide, the active ingredient in Mounjaro, resulted in greater weight loss within one year of treatment. Individuals taking tirzepatide were more likely to achieve meaningful body weight reduction at three, six, and 12 months compared to those on semaglutide.

According to Eli Lilly, participants in Mounjaro clinical trials lost between 12 and 25 pounds. The trials reported an average weight loss of 21.1 percent after 12 weeks and a total mean weight loss of 26.6 percent over 84 weeks.

In contrast, clinical trials conducted by Novo Nordisk found that Ozempic users lost between 9.3 and 14.1 pounds. On average, participants lost about 15 percent of their body weight after 68 weeks of treatment.

Is Mounjaro More Effective Than Ozempic?

The answer depends on individual health goals and medical needs. Mounjaro is widely recognised for its strong impact on lowering A1C levels and promoting weight loss. Ozempic, meanwhile, not only helps control blood sugar but is also approved to reduce cardiovascular risk in people with Type 2 diabetes.

Head-to-head research suggests that Mounjaro may offer greater reductions in both blood sugar and body weight. In the SURPASS-2 trial, tirzepatide outperformed semaglutide in lowering A1C levels. The 5 mg, 10 mg, and 15 mg doses of tirzepatide reduced A1C by 2.01, 2.24, and 2.30 percentage points respectively, compared to a 1.86-point reduction with the 1 mg dose of semaglutide.

Read: WHO Issues First Guidance On Obesity Drugs — GLP-1 Drugs Get the Green Light

How Do Mounjaro and Ozempic Side Effects Compare?

Both medications share similar side effects, most commonly gastrointestinal issues such as nausea and vomiting. However, some data suggest that side effects with Mounjaro may be slightly more frequent or severe.

The SURPASS-2 trial found that the most common side effects were generally comparable between tirzepatide and semaglutide. However, tirzepatide was associated with a slightly higher rate of serious adverse events.

Mounjaro’s prescribing information includes a warning about severe gastrointestinal disease, a caution not listed in Ozempic’s label. Clinical trials also showed that more patients discontinued Mounjaro due to gastrointestinal side effects. For both drugs, higher doses were linked to an increased likelihood of side effects.

Ultimately, how a person responds to either medication can vary. Each drug works differently in the body, and individual tolerance, medical history, and treatment goals all play a role in determining which option may be more suitable.

Difference Between GLP-1 Drug and GIP Drug

GLP-1 Drugs

GLP-1 drugs mimic the action of the natural hormone GLP-1 to regulate blood sugar and promote weight loss. They work by increasing insulin release in a glucose-dependent manner, decreasing the liver's production of glucagon, and slowing down the emptying of the stomach, which helps lower blood sugar levels after a meal. They also act on the brain to suppress appetite and increase feelings of fullness, leading to reduced calorie intake.

In people with type 2 diabetes, notes Harvard Health, the body's cells are resistant to the effects of insulin and body does not produce enough insulin, or both. This is when GLP-1 agonists stimulate pancreas to release insulin and suppress the release of another hormone called glucagon.

These drugs also act in the brain to reduce hunger and act on the stomach to delay emptying, so you feel full for a longer time. These effects can lead to weight loss, which can be an important part of managing diabetes.

GIP Drugs

As per the American Diabetes Association's published study, Gastric inhibitory peptide (GIP) is best known for its role as an incretin hormone in control of blood glucose concentrations.

GIP is produced from a larger 153–amino acid precursor protein encoded by the GIP gene. In the bloodstream, it circulates as an active 42–amino acid peptide. It is synthesised by K cells located in the lining of the duodenum and jejunum in the small intestine.

Like other endocrine hormones, GIP is released into the bloodstream and travels to target organs through circulation. Its receptors are seven-transmembrane G protein–coupled receptors (GPCRs) found primarily on the beta cells of the pancreas.

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Fact Check: Common Myths Around HPV Vaccine And How It Will Prevent Cervical Cancer

Updated Feb 28, 2026 | 08:00 PM IST

SummaryThe national program will use Gardasil, a quadrivalent HPV vaccine that protects against HPV types 16 and 18, which cause cervical cancer, as well as types 6 and 11. Countries with early HPV vaccine adoption have also shown large declines in HPV infection, high-grade cervical lesions, and cervical cancer incidence.
Fact Check: Common Myths Around HPV Vaccine And How It Will Prevent Cervical Cancer

Credit: Canva

In a major push towards eliminating cervical cancer from India, Prime Minister Narendra Modi today launched the nationwide Human Papillomavirus (HPV) vaccination program for girls aged 14 years.

The new vaccination drive comes as cervical cancer remains the second most common cancer among women in India, with nearly 80,000 new cases and over 42,000 deaths reported annually. As per data from the ICMR-National Cancer Registry Program (NCRP), an estimated 78,499 new cases and 42,392 deaths were reported in 2024.

Calling it a "decisive step”, the government noted that it is aimed at “strengthening the vision of ‘swasth nari’ (healthy women) while being rooted in scientific evidence, strict regulatory oversight and global best practices”.

“India's vaccination drive reflects safety, responsibility, and long-term commitment to women’s health,” it added.

The national program will use Gardasil, a quadrivalent HPV vaccine that protects against HPV types 16 and 18, which cause cervical cancer, as well as types 6 and 11.

However, social media has been rife with concerns around the safety of the vaccine, its impact on women’s reproductive health, among others.

HPV Vaccine: The Myths And Facts

Myth: HPV vaccines can cause severe side effects and even death.

Fact: The HPV vaccines come with a “confirmed strong safety record”.

“Extensive global monitoring shows a strong safety profile supported by scientific reviews. Independent evaluations have found no causal link between vaccination and chronic harm, strengthening confidence in its continued use worldwide,” the government said.

The vaccine has been licensed in India since 2008, and the new rollout follows recommendations by the World Health Organization (WHO) and approvals from the National Technical Advisory Group on Immunization (NTAGI).

“HPV vaccines have been given to hundreds of millions globally. Extensive post-marketing surveillance shows an excellent safety profile, with no causal link to serious adverse outcomes. The evidence is robust, transparent, and reassuring,” Dr. CS Pramesh, Director of the Tata Memorial Hospital, Mumbai, shared in a post on the social media platform X.

Myth: The HPV vaccine has never been used in India

Fact: The vaccine has been in use in India. It has been administered for years since 2008 with successful implementation in states like Punjab, Sikkim, and Tamil Nadu.

Myth: HPV vaccination does not prevent cervical cancer

Fact: The HPV vaccine has been proven to prevent cervical cancer

Studies show a 65 percent drop in cervical cancer cases among US women between 2012 and 2019 and an 88-89 percent reduction in precancerous lesions among Scottish women over a decade.

Countries with early HPV vaccine adoption have also shown large declines in HPV infection, high-grade cervical lesions, and cervical cancer incidence.

"Even when considering the rarest side effects, HPV vaccines are overwhelmingly safe. The protection they offer against cervical cancer far outweighs the minimal risks. Parents are encouraged to vaccinate their daughters on time," said Dr. Neena Malhotra, Professor and Head of Department, Department of Obstetrics and Gynecology, AIIMS New Delhi on X.

Myths: Are Multiple Doses Needed?

Fact: A single dose of the quadrivalent HPV vaccine is effective. It provides strong protection against HPV infection. It helps prevent cervical cancer.

“Strong global and Indian scientific evidence confirms that a single dose provides robust and durable protection when administered to girls in the recommended age group," the government said.

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