Buzz
Western nations have experienced a dramatic rise in neurological conditions, such as early-onset dementia, which cannot be solely attributed to increased life expectancy. Interestingly, certain brain disorders exhibit such peculiar symptoms that they are often misidentified as psychiatric illnesses.
10. Anti-NMDA Receptor Encephalitis
Anti-NMDA receptor encephalitis, a recently identified autoimmune disorder causing brain inflammation, often begins with psychiatric manifestations like hallucinations, aggressive behavior, and delusions. Patients may seem as though they are under the influence of demons, and most will experience seizures and uncontrollable movements within days.
However, the neurological signs can be quite subtle and often overlooked. According to Dr. Souhel Najjar, a specialist in anti-NMDA cases, up to 90 percent of these instances may have been incorrectly diagnosed. “There might be individuals in comas or confined to psychiatric facilities who suffer from this condition and are not receiving appropriate care,” Emily Gavigan, an anti-NMDA patient, shared with CBS Eyewitness News.
Susannah Cahalan, a 24-year-old woman, incurred over $1 million in medical expenses under the care of leading specialists, yet her condition was repeatedly misidentified. She experienced seizures and hallucinations—growling like an animal, she lashed out at others. She believed newscasters were talking about her on television. Dr. Najjar intervened and requested her to sketch a clock face. When she clustered all the numbers on one side, Dr. Najjar recognized inflammation on the right side of her brain. Susannah received timely treatment, preventing a coma and potential fatality.
While Susannah made a full recovery without any lasting brain damage, not all patients are as fortunate. Even with medical intervention, around 7 percent of individuals succumb to the disease, and others endure varying degrees of brain damage. Anti-NMDA can be managed with immunotherapy, but a definitive cure remains elusive—only remission is possible. A recurrence necessitates further treatment.
Anti-NMDA has motivated Dr. Najjar to explore other conditions typically classified as psychiatric—such as bipolar disorder, depression, obsessive-compulsive disorder, and schizophrenia—to determine if they might also stem from physical causes like brain inflammation.
9. Othello Syndrome
Othello syndrome (OS) derives its name from Shakespeare's character Othello, who murdered his wife, Desdemona, under the false belief that she was unfaithful. Individuals with OS exhibit persistent delusions of mistrust and jealousy toward their partners, frequently accusing them of cheating. Some even experience hallucinations of their spouse engaging in sexual activity with another person.
OS typically emerges around the age of 68, with approximately 77 percent of patients suffering from a neurological disorder affecting one of the brain's frontal lobes, often the right side. In some cases, OS is triggered by dopamine therapy used to treat Parkinson’s disease. If this is the cause, reducing or discontinuing the medication may help mitigate OS symptoms.
In Lewy body dementia (LBD), OS symptoms may persist or even begin after the death of a spouse. LBD encompasses Parkinson’s disease and dementia resulting from protein deposits—known as Lewy bodies—in the brain's nerve cells.
A 42-year-old man undergoing dopamine agonist treatment for Parkinson’s began demanding frequent sexual activity with his wife. Consumed by accusations of infidelity, he fixated on his driveway, convinced that an imaginary lover would arrive to take her away for an affair. He also squandered thousands of dollars on impulsive gambling and struggled to control his spending habits.
Similar to Othello, individuals with OS can exhibit dangerously aggressive behavior. Men suffering from OS have attempted to choke their spouses or instigate altercations with neighbors they suspect of being their wives' lovers.
8. Sensory Desynchronization
“PH,” a retired pilot in his sixties, was the first documented case of sensory desynchronization, a condition where a person hears voices before the speaker actually speaks. For PH, life resembles watching a film where the audio and visuals are out of alignment. He even hears his own voice before sensing his mouth move. Brain imaging showed lesions in his midbrain and brain stem, areas linked to hearing, movement, and timing.
Researchers theorize that our brains process visual and auditory information at different rates to account for the varying speeds of light and sound. For most people, the brain seamlessly synchronizes voices with lip movements. However, PH experiences a quarter-second delay between hearing a voice and seeing the corresponding mouth movement. To realign these, scientists played audio clips where voices preceded lip movements by 210 milliseconds.
The mechanism by which the human brain synchronizes visual and auditory perceptions remains a mystery. However, it highlights that our brains contain multiple internal clocks. When these clocks fail to coordinate properly, the auditory and visual aspects of our experiences can fall out of alignment.
7. Ecstatic Epileptic Seizures
Ecstatic epileptic seizures, or ecstatic auras when occurring at the onset of a seizure, were vividly described by the renowned epileptic author, Fyodor Dostoevsky: “I would feel a joy unimaginable in ordinary life . . . I sensed absolute harmony within myself and the universe, a sensation so intense and delightful that I would willingly trade years, or even my entire life, for a few moments of such bliss.”
A 53-year-old teacher recounted her ecstatic seizure as follows: “The experience was almost otherworldly. It brought an overwhelming sense of tranquility, peace, and freedom from worry; everything felt exquisite and perfect . . . The closest comparison might be an orgasm, though what I felt was entirely non-sexual . . . it was profoundly spiritual.” She added that the experience eradicated her fear of death and enhanced her perception of the world’s vibrancy.
Some researchers suggest that ecstatic seizures may provide insight into near-death experiences. While the exact mechanisms remain unclear, it is known that these seizures affect only 1–2 percent of individuals with temporal lobe epilepsy. Those who experience them describe an elevated sense of well-being and increased self-awareness. Many also mention a sensation of time standing still, accompanied by profound peace and joy, though occasionally overwhelmed by the intensity of the experience.
These seizures often originate in one of the brain’s temporal lobes. Some neurologists propose that the insular cortex, located beneath the temporal lobe, is the actual site of this activity. Unlike the temporal lobes, the anterior insula is thought to be closely tied to our emotional experiences, both positive and negative.
6. Misophonia
Individuals with misophonia react with intense anger or distress to subtle sounds that most people ignore or overlook, such as chewing gum, slurping soup, or faint footsteps. Their heart rates spike, their fists tighten, and they experience overwhelming rage or anxiety. Unlike hyperacusis sufferers, who find all sounds excessively loud, those with misophonia tolerate loud noises but are deeply disturbed by softer ones.
Misophonia typically emerges in late childhood or early adolescence. Over time, the condition worsens, and individuals develop more trigger sounds—sometimes even breathing can provoke a reaction. Those affected do not grow out of it. As Adah Siganoff, a patient, explained, “It’s all about the reaction. The rage. The anger. The inability to control it. For people with this disorder, the sound feels like 200 people dragging their nails across a chalkboard simultaneously. It’s that intense and utterly overwhelming.”
Many patients have been incorrectly diagnosed with psychiatric disorders, such as post-traumatic stress disorder. However, some medical professionals are starting to acknowledge misophonia as a neurological condition potentially caused by abnormal brain wiring in emotional regulation areas. Despite this, many doctors remain skeptical, and treatment options are currently limited and often ineffective. Most sufferers manage by isolating themselves during meals or venting their frustration through screaming. Others rely on earplugs to mute triggering sounds.
5. Developmental Topographical Disorientation
Imagine being disoriented daily—even in your own home—and you might grasp how Sharon Roseman from Littleton, Colorado, feels. Now in her sixties, Sharon has lived with developmental topographical disorientation (DTD) since age five. DTD is a rare neurological disorder that renders a person incapable of orienting themselves or navigating any space. When Sharon couldn’t recognize her house as a child, her mother cautioned, “Don’t tell anyone, or they’ll call you a witch and burn you.”
Sharon kept her condition hidden, not even confiding in her husband. Her struggles became so severe that she often couldn’t locate her crying children at night. While driving, curved roads, angles, and even bodies of water like oceans, lakes, and pools leave her utterly disoriented. As Sharon described it, “It feels as though someone lifts the entire world, rotates it, and places it back down.”
At 29, Sharon sought medical help and consulted a psychologist, but her disorientation remained untreatable. She was later misdiagnosed with a brain tumor or epilepsy, both of which were ruled out. Eventually, she met Guiseppe Iaria, a neuroscience professor at the University of Calgary. Dr. Iaria, who published the first paper on DTD in 2008, immediately recognized Sharon’s condition.
The exact neurological mechanisms behind DTD remain unclear. Brain scans show no signs of atrophy or shrinkage. However, Jeffrey Taube, a Dartmouth College professor, suggests that the brain’s mapping processes in DTD patients fail to communicate effectively, and their internal navigation systems are disrupted.
There is currently no cure for DTD. For now, Sharon finds solace in being able to explain her condition to others without fear of being labeled insane or accused of witchcraft.
4. Musical Hallucinations
A woman named “Sylvia” once heard piano music outside her home, only to realize it was a musical hallucination. These hallucinations feel so real that patients often believe a live performance is happening nearby. Over time, Sylvia’s hallucinations grew nearly continuous, featuring extended classical pieces by composers like Rachmaninoff.
Musical hallucinations can stem from psychiatric conditions such as depression, obsessive-compulsive disorder, and schizophrenia. However, in most cases, they are not linked to psychosis. Instead, they often occur in older individuals with hearing loss, whose brains misinterpret auditory signals. This is the prevailing theory among doctors who have studied Sylvia and similar patients.
Sylvia found that listening to actual music temporarily halted her hallucinations. By scanning her brain during both live music and silence, doctors identified the regions that became more active as the hallucinations intensified. These studies suggest that the brain hears a single note or chord and predicts subsequent ones based on past experiences. If the prediction is wrong, the brain adjusts its forecast to reduce errors.
In individuals with hearing impairments, the brain receives fewer auditory cues, leading to more prediction errors. As these errors accumulate, they become vivid and realistic to the patient. Doctors theorize that music is the most common hallucination because its structured nature makes it easier for the brain to predict compared to random sounds.
3. McLeod Syndrome
McLeod syndrome, caused by a genetic mutation in the XK gene, is a rare neurological disorder that typically emerges in midlife and affects only around 150 men globally. Half of the patients experience seizures, while other symptoms include muscle weakness, atrophy, involuntary limb movements, facial grimacing, and vocalizations such as grunting and cognitive decline.
The unusual behavioral changes associated with McLeod syndrome often lead to misdiagnosis as a psychiatric condition. Early signs include depression, anxiety, and extreme emotional instability, including a loss of self-control. There is no cure, but treatments can help manage symptoms.
Researchers from Southern Methodist University suggest that McLeod syndrome might explain King Henry VIII of England’s execution of two of his six wives. Initially, Henry VIII was robust, athletic, and benevolent. However, around age 40, he developed leg weakness and atrophy, eventually becoming immobile. He also exhibited psychotic paranoia, which led to the execution of his wives.
McLeod syndrome is linked to the Kell blood group, which could also explain the complications during the pregnancies of Henry VIII’s wives and mistresses. They carried at least 11 of his children, but only four survived infancy. If Henry VIII had the Kell antigen in his blood and his partners did not, they could only bear a healthy first child before experiencing subsequent losses.
2. Frontotemporal Dementia
Unlike Alzheimer’s, which starts with memory loss and later leads to behavioral issues, Frontotemporal dementia (FTD) begins with behavioral changes due to the death of nerve cells in the frontal lobes. As the damage spreads, memory loss follows. Over time, FTD and Alzheimer’s become nearly indistinguishable in their presentation.
FTD typically affects individuals aged 45–65, younger than the usual onset of Alzheimer’s. The behavioral variant, bvFTD, has early symptoms that closely resemble psychiatric disorders. Physically, FTD causes atrophy in the brain’s frontal and temporal lobes. Like all forms of dementia, it strips patients of their lives, relationships, and dignity. As one caregiver expressed, “Caring for someone with this disease feels like mourning them while they’re still alive.”
Barbara Whitmarsh, a former scientist at the National Institutes of Health, shared a 30-year marriage with her husband, John, and raised six children together. Over time, John observed dramatic changes in Barbara due to her FTD. He remarked, “Her empathy and personality gradually vanished.” Additionally, she gained 15 kilograms (30 lb) in just one year.
Patients with bvFTD may develop unusual cravings for sweets. They are also prone to violent episodes, a lack of self-control, and poor emotional decision-making. Symptoms can include hyperactivity, hypersexuality, and impulsivity. However, the most challenging aspect for families is the patient’s emotional detachment from loved ones. Compounding the issue, FTD patients often fail to notice their behavioral changes.
Barbara Whitmarsh no longer recognizes her family and rarely speaks. She resides in a secure nursing home, where she remains in constant motion.
1. Huntington’s Disease
Huntington’s disease (HD), caused by a mutation in the Huntingtin gene, is a rare genetic disorder that progressively damages nerve cells in the brain, impacting behavior and movement. The musician Woody Guthrie succumbed to the disease after years of misdiagnosis. Currently, there is no cure.
Some individuals, like Katharine Moser, undergo early testing to determine if they carry the genetic mutation responsible for HD, which typically doesn’t appear until middle age. Unfortunately, many HD patients hesitate to disclose their condition due to fear of stigma and workplace discrimination. As Ms. Moser’s mother noted, “People lack empathy. They stare at you as if you’re odd, asking, ‘What’s wrong with you?’”
Katharine Moser witnessed the devastating effects of HD on her grandfather during her youth. He experienced involuntary body jerks and violent episodes. On one occasion, he walked into the kitchen wearing only underwear on his head.
In its initial stages, HD symptoms differ among patients. However, the earlier symptoms appear, the quicker the disease advances. Early signs often include mood swings, with patients experiencing depression, irritability, apathy, or anger. HD can also impair memory, judgment, and learning abilities, gradually affecting intellectual functions over time.
For some patients, the first indicators are involuntary movements in the face, feet, fingers, or torso. Issues with balance or coordination may also arise. As the disease progresses, basic abilities like eating, speaking, and walking deteriorate. At present, the outcome is invariably fatal.
+Alien Hand Syndrome
The corpus callosum, a bundle of nerve fibers, facilitates communication between the brain’s right and left hemispheres. In some epilepsy cases, surgeons sever this structure to control seizures. While most patients recover normally, others experience the two brain hemispheres functioning independently, as if an alien has taken control of one side of the body. This phenomenon is aptly named alien hand syndrome (AHS).
Nobel laureate Roger Sperry documented an AHS patient attempting to arrange blocks to match a pattern. The left hand, governed by the right brain, performed well, while the right hand struggled. When the left hand tried to assist the right, the two hands clashed like quarreling children.
Karen Byrne’s epilepsy was successfully treated by severing her corpus callosum. However, her doctor once observed her left hand unbuttoning her shirt without her awareness. After she rebuttoned it with her right hand, the left hand began undressing her again.
Occasionally, the alien hand may strike or hit the patient. Alternatively, if the legs are directed to move in opposing directions, the individual may end up walking in circles as the brain’s hemispheres battle for control. Fortunately, Karen’s doctors have managed to alleviate her symptoms through medication.
