Recovery from an autoimmune inflammation of the brain may take three years or more, according to a study published in the November 20, 2024, online issue of Neurology . Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is brain swelling caused when the immune system attacks the brain. A patient memoir titled "Brain on Fire" and a film based on the book have increased awareness of the disease first identified in 2005.

Anti-NMDAR encephalitis is rare and primarily affects young adults. Symptoms start with headache, fatigue and fever and progress to confusion, memory loss , movement problems, behavioral and personality changes, disordered thinking or speaking, hallucinations, seizures and even loss of consciousness. It may be misdiagnosed as schizophrenia or bipolar disorder .

Ovarian tumors and previous brain swelling from herpes simplex virus have been identified as causes, but in most cases the cause is unknown. It can be treated with immunotherapy. "While more than 80% of people treated for anti-NMDAR encephalitis return to living independently after one to two years, most report continued thinking and memory problems as well as social difficulties ," said study author Maarten Titulaer, MD, Ph.

D., of Erasmus University Medical Center in Rotterdam, the Netherlands, and member of the American Academy of Neurology. The study involved 92 people with an average age of 29 who had been diagnosed with anti-NMDAR encephalitis in the Netherlands prior to 2023.

Researchers r.