I am amazed every time I learn more and more about autoimmune disorders and how destructive they can be on our body. I think it is scary and I find being more scared of the effects on the brain.
Autoimmune Brain Disease
Autoimmune Brain Disease or “AIBD” consists of a syndrome of the central nervous system which is caused by antibodies or immune cells which are attacking the brain.
How common is autoimmune brain disease?
ABD is rare, probably accounting for less than 1% of all cases of central disturbances.
The diagnosis is based on history, findings on physical examination, blood tests, and the results of other tests.
Several things can be done to treat AIBD. In cases with a rapid progressive impairment, a trial of steroids (Prednisone or Decadron) for 4 weeks may be tried. In people who respond to steroids, in most cases a chemotherapy type of medication such as Cytoxan or Methotrexate will be used over the long term ). It has also recently been reported that plasmapheresis may be beneficial.
Plasmapheresis is a new medical term to me. Here is the definition: This procedure replaces blood plasma with new plasma to stop antibodies from attacking healthy cells. This procedure may need to be repeated several times.
AE is a serious medical condition in which the immune system attacks the brain, impairing function. With rapid diagnosis and appropriate treatment, many patients recover most or all functions. However, not all patients experience full recovery; with approximately 6% mortality and other patients who never regain significant brain and/or bodily functions.
Have you seen the movie “Brain on Fire”? This movie is based on the true story of a woman who had AE. This movie is riveting to watch and I felt very bad for the patient. When the doctor who could help her came into her life, he was like that knight in shining armor.
The movie Brain on Fire is a true story that is about a patient with this disease and how it was discovered and treated.
The direct cause of most cases of AE remains unknown. However the following have been shown to trigger AE:
- a teratoma ( a type of tumor, generally found in the ovaries). A teratoma or cancer is found only in a small minority of AE patients.
- the presence of a cancer in the body , that indirectly triggers an autoimmune response (this is called a “paraneoplastic syndrome”)
- exposure to certain common bacteria, including, but not limited to, streptococcus and mycoplasma pneumonia, with or without active infection.
It is unfortunate that the immediate trigger of many episodes of AE remains unknown.
As soon as a patient is diagnosed with AE, they should receive one or more of the four first-line treatments.
- removal of a teratoma (if present) that could be triggering the autoimmune response
- steroids to reduce immune response and inflammation
- plasmapheresis to remove harmful antibodies from blood
- intravenous immunoglobulin (IVIG), which is believed to occupy the binding sites where harmful antibodies attach to brain cells.
“Second line” treatments—immunosuppressant drugs—should begin promptly if first-line treatments fail to improve symptoms. The three most commonly used drugs are:
- Rituximab: is cell-targeted antibody injection that helps the immune system destroy certain blood cells that may cause the immune system to create autoantibodies.
- CellCept: is an oral immunosuppressant, originally prescribed to patients undergoing organ transplant surgery, but now is recommended as a possible “second line” defense in AE. CellCept interferes with the formation of DNA in certain immune system cells that become overactive in cases of autoimmune disorders.
- Cytoxan(cyclophosphamide): is a chemotherapy drug that comes in tablet or injectable form. It works by slowing or halting the growth of immune system cells. Common side effects include nausea, vomiting, and hair loss. Less common but more serious side effects include damage to the bladder, fertility problems, and bone marrow suppression.
This sounds very serious to me. Vasculitis is an inflammation of the blood vessels of the brain; which can cause confusion, seizures, headaches, and unconsciousness.
Vasculitis of the central nervous system (CNS) is the inflammation of blood vessels in the brain and spinal cord.
Vasculitis anywhere in the body is usually accompanied by systemic symptoms like fever, involuntary weight loss and/or fatigue.
Symptoms that may accompany vasculitis in the brain include:
- severe headaches
- stroke-like symptoms
- difficulty with coordination
- or other changes in mental status.
Vasculitis of the spine may cause shooting pains in the arms and legs, numbness and asymmetrical weakness.
In some cases, the disease may be acute for a time, and then enter periods of remission. In other cases, vasculitis may be chronic.
Just like with other autoimmune disorders and the immune system being attacked because it doesn’t recognize healthy body parts, vasculitis, misidentifies parts of blood vessel walls as harmful and attacks the vessel walls, causing them to become swollen and inflamed.
Surgical treatment for vasculitis may be necessary when vasculitis causes an aneurysm to develop. Aneurysm treatment may include clipping, (Clipping is a way to treat an aneurysm by placing a small metal clip across the neck of the aneurysm- the base of the bulge. The aneurysm is thereby sealed off from the blood flow; it cannot burst or spill blood into the brain.) coiling, (a technique that places a stent at the point of the aneurysm and inserts a coil into the bulging blood vessel. The coil forms a clot that treats the aneurysm.) or flow diversion.
To learn more about vasculitis visit the vasculitisfoundation.org.
Lupus is so damaging and seems to be able to attack any part of the body. I already don’t like it that it can affect the heart, but I really am not that thrilled that it can affect our brain.
Lupus can affect both the central nervous system (the brain and spinal cord) and the peripheral nervous system. Lupus may attack the nervous system via antibodies that bind to nerve cells or the blood vessels that feed them, or by interrupting the blood flow to nerves.
Signs of this are:
- problems concentrating or remembering things
- and trouble sharing thoughts.
One out of five people with lupus have headaches, dizziness, memory loss, stroke, or mood swings that result from changes in the brain or spinal cord. These people have central nervous system lupus. Other symptoms can include:
- problems with memory
- problems with vision
- depression (deep sadness, hopelessness, loss of pleasure)
- and psychosis (delusions, paranoia, hallucinations).
A doctor can recommend a combination of treatments that include:
- anti-inflammatory and anti-malarial medicines
- blood thinners
- drugs to ease tiredness and depression
- and counseling
RA is best known for causing painful, swollen joints. Research shows that many people with RA say they also have to deal with symptoms like forgetfulness, trouble concentrating, and difficulty thinking clearly. A sense of mental slipping is known as “brain fog.”
There are a few possibilities thought to be a cause of the “brain fog”, but none of them have been proven.
- Get a full night’s sleep. This is a natural way to treat “brain fog”. Go to bed and get up in the morning at specific times. Use ambient music to help you sleep and keep the room dark and cool.
- Certain medications may improve or prevent “brain fog“. By relieving pain, medication can also provide relief from the constant distraction it causes.
- Be organized. Make a to-do list for your daily tasks. I find it so much easier to work from a list! It is a great source of stress relief to have my tasks written down and organized.