Before she became a patient, April had been an outgoing, straight-A student majoring in accounting at the University of Maryland Eastern Shore. But after a traumatic event when she was 21, April suddenly developed psychosis and became lost in a constant state of visual and auditory hallucinations. The former high school valedictorian could no longer communicate, bathe or take care of herself...Markx and his colleagues discovered that although April’s illness was clinically indistinguishable from schizophrenia, she also had lupus, an underlying and treatable autoimmune condition that was attacking her brain. After months of targeted treatments — and more than two decades trapped in her mind — April woke up.
April had undergone many courses of treatment — antipsychotics, mood stabilizers and electroconvulsive therapy — all to no avail... Even though April had all the clinical signs of schizophrenia, the team believed that the underlying cause was lupus, a complex autoimmune disorder in which the immune system turns on its own body, producing many antibodies that attack the skin, joints, kidneys or other organs. But April’s symptoms weren’t typical, and there were no obvious external signs of the disease; the lupus appeared to be affecting only her brain...
As part of a standard cognitive test known as the Montreal Cognitive Assessment (MoCA), she was asked to draw a clock — a common way to assess cognitive impairment. Before the treatment, she tested at the level of a dementia patient, drawing indecipherable scribbles. But within the first two rounds of treatment, she was able to draw half a clock — as if one half of her brain was coming back online, Markx said. Following the third round of treatment a month later, the clock looked almost perfect...
While it is likely that only a subset of people diagnosed with schizophrenia and psychotic disorders have an underlying autoimmune condition, Markx and other doctors believe there are probably many more patients whose psychiatric conditions are caused or exacerbated by autoimmune issues.
Oddly enough, some years ago Enbrel was given to Alzheimer patients. In minutes, it had done WONDERS. But news that should have enthused everyone...virtually vanished overnight. No answer to why--and yet it seems they had found a breakthrough treatement.
ReplyDeleteWhat a story, had to read it all. Thanks.
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ReplyDeleteThat test is fine for older persons living know, who still know what a clock face looks like. In 30 years or so, the older persons then will fail that test, as they will draw a box with 4 numbers in it.
ReplyDeleteI raised that same point back in 2012 when my mother was being assessed for dementia -
Deletehttps://tywkiwdbi.blogspot.com/2012/02/is-clock-face-still-appropriate.html
@ Anonymous: I'm not sure how much different things are across the pond (if that's where you're located) but here in my European country, analog clocks are as ubiquitous as digital ones. They're in my home, at the office where I work, and on every church tower I come across. I'm 45 now, so assuming my body still functions properly 30 years hence, I'm fairly confident that I'll remember how to draw one.
DeleteAnd I even forgot to mention the most ubiquitous presence: train stations. In my country, millions of people travel by train multiple times a day, and each platform has one or several analog clocks on it, so most people see them all the time, every day. The station clocks don't have the numbers on them by the way, only the hands and hour/minute markings. As far as I'm aware, very few people have trouble reading them - perhaps only small children and people who haven't lived here very long yet. But I'm not sure of that; maybe clock reading skills are dwindling as alarmingly fast as spelling skills are.
DeleteI just now noticed that, while April's drawing got better with treatment, the first one is the only one that has the requested time correct. And that first drawing has all the necessary information.
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