Netflix's 'Brain on Fire' reveals the terrifying illness that plagued Susannah Cahalan
'Brain on Fire,' a biographical drama film directed and written by Gerard Barrett and based on Susannah Cahalan's New York Times best-selling autobiography 'Brain on Fire: My Month of Madness,' had its world premiere at the Toronto International Film Festival on September 14, 2016 and released on Netflix yesterday after the streaming giant acquired the distribution rights. The film stars Chloë Grace Moretz in the titular role of Susannah Cahalan, with Jenny Slate, Thomas Mann, Tyler Perry, Carrie-Anne Moss, and Richard Armitage cast in supporting roles.
It follows Cahalan, who is in her early 20s and has just landed her dream job at the New York Post, as she begins experiencing strange phenomena — she goes into trances, sees people who are not present talking about her, is constantly paranoid, and becomes painfully sensitive to annoying noises — and her behavior becomes increasingly erratic. Her health continues to deteriorate, and she eventually suffers a seizure that sees her admitted to the hospital where the doctors are baffled by her condition.
Expert after expert examine Cahalan and none seem to be able to figure out what's wrong with her. One says she's bipolar, the other schizophrenic, and yet another psychotic. None are correct. Her parents and friends are getting desperate, but the doctors remain adamant that her prescribed medicines will cure her of her ailment. When the situation degrades further, it's Dr Souhel Najjar who hits the nail on the head with his diagnosis; one so rare that it was only discovered three years prior and which, at the time, didn't have a name.
While her condition was not revealed until the very end of the movie, Cahalan was diagnosed with anti-NDMA receptor encephalitis, an acute form of brain inflammation that is potentially lethal but is treatable and manageable if caught early. It is caused by the person's immune system targeting and attacking the NR1 subunit of the NMDA receptor, which is found in nerve cells and is responsible for synaptic plasticity and memory function.
One of the reasons it was so difficult to diagnose — and why different doctors offered different diagnoses — is because encephalitis presents itself differently in different patients. Speaking to Oprah.com, Cahalan had explained: "NMDA receptors are concentrated in the areas that control learning and memory, higher functions like multitasking, and some of the more subtle aspects of personality."
"When the immune system makes antibodies that attack these receptors, people may have seizures and violent fits. They might act psychotic and paranoid, like I did, or become hypersexual and lewd. How you respond depends on the area of the brain that's most affected and the number of receptors damaged," she continued.
Cahalan was just the 217th person in the world to be treated for the disease, which was diagnosed because Najjar had the presence of mind to prescribe Cahalan a 'Draw a Clock' test that is reserved for those with Alzheimer's and dementia. Tasked with drawing a clock, Cahalan jammed all the numbers on the right side of the clock face, confirming that her condition was neurological and not psychiatric.
A course of steroids, several immune therapies, and months of readjustment saw her finally regain her old life. Today, she is married to her then-boyfriend Stephen Grywalksi and retains her job at the New York Post.