She Spent 20 Years in a Psychiatric Hospital. Then She Woke Up.

April Burrell lived in a psychiatric hospital for 20 years because her catatonic state left her immobile and unresponsive. But after 2 decades, she suddenly woke up.

At the age of 21, April, a high school valedictorian and accounting major at the University of Maryland Eastern Shore, suddenly developed a severe form of schizophrenia.
Her psychosis caused visual and auditory hallucinations. Unable to take care of herself, she was admitted to a psychiatric hospital.

Sander Markx, director of precision psychiatry at Columbia University, met April as a patient while he was a medical student in 2000.

“She is, to this day, the sickest patient I’ve ever seen,” he recalls.
Little did he know he would cross paths with April 18 years later. In 2018, Markx encouraged one of his research fellows to spend time at the same hospital where he had met April 18 years earlier.

Upon their return, a "trainee, Anthony Zoghbi, encountered a catatonic patient standing at the nurses’ desk. The fellow returned to Markx, shaken up, and told him what he had seen."

Markx recalls a moment of déjà vu as he tells this story, when he asks Anthony, “Is her name April?”

That's when he realized April was not only still there but still catatonic. Dr. Markx and colleagues investigated April's case further.

They discovered that April, in addition to schizophrenia, also had Lupus, an autoimmune disease. Lupus, unlike schizophrenia, can be effectively treated with medication by suppressing the immune system.

So a team of physicians started treating her. Every month for six months, April would "receive short, but powerful pulses" of intravenous steroids for five days, plus a single dose of cyclophosphamide, a heavy-duty immunosuppressive drug typically used in chemotherapy..."

After her first treatment, April woke up.

After her 3rd round of treatment, she could accurately draw a clock, something she hadn't been able to do in 20 years. Her miraculous response to treatment suggested that April's psychosis was caused by an autoimmune attack on her brain.

Dr. Markx believes April's immune system was making autoantibodies that were attacking her temporal lobe (🧠 ), areas implicated in schizophrenia.

This is a powerful story revealing that a rogue immune response can change how we think, feel, and act. How many other inpatients are sitting in psychiatric hospitals with neuronal autoantibodies attacking their brains?

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