Rare Brain Disorder Does Not Derail Future Career in Medicine
Tuesday, August 16, 2022
In May 2020, Rachael Muggleton was wrapping up her third year of pre-med studies at Penn State University when she unexpectedly and rapidly fell ill, victim to a rare and dangerous inflammation in the brain. She details her remarkable journey in a piece on the Neurocritical Care Society website, in which she describes her decline in health, months-long stay at Strong Memorial Hospital, and remarkable recovery.
Initially admitted to Arnot-Ogden Medical Center in her hometown of Elmira, NY, Rachael was quickly transferred to the Neuromedicine Intensive Care Unit (NMICU) at Strong, where physicians put her in a 42 day medically-induced coma to control her seizures, as a multidisciplinary team of specialists strove to calm her brain and immune system.
Rachael suffered from a rare and complex condition called autoimmune encephalitis (AE), an inflammation in the brain triggered by the body’s own immune system attacking healthy brain cells, which can result in seizures, impaired memory and cognition, and problems with balance, speech, and vision. Tests determined she had a specific type of AE characterized by the creation of antibodies that attack NMDA receptors, which reside at the connections between neurons, disrupting normal signaling between nerve cells and triggering inflammation. This form of AE is more common in women and can be associated with certain cancers, however, the source of the damaging immune response sometimes cannot be identified, as was the case with Rachael.
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Article Details Baseball Player’s Road to Recovery after Devastating Brain Injury
Monday, February 14, 2022
On July 31 last year, Daniel Brito, third basemen for the Lehigh Valley Iron Pigs, had just taken the field in the bottom of first inning during the first game of a planned double header against the Rochester Red Wings when the unthinkable happened. A tangle of abnormal blood vessels – called an arteriovenous malformation (AVM) – burst in his brain and triggered a seizure. Brito collapsed in the infield, the game was halted, an ambulance was brought onto the field, and he was rushed to UR Medicine’s Strong Memorial Hospital.
While those frightening scenes at Frontier Field were reported by the media, the full story of what occurred that day and Brito’s remarkable journey to recovery from a dangerous and potentially deadly brain injury is only now being fully told in a story appearing in The Athletic.
“Everything that happened to Daniel felt like it was one in a million,” said Debra Roberts, M.D., the director of the UR Medicine Neuromedicine Intensive Care Unit which was Brito’s home for almost two months as he recovered from the damage caused to his brain. “A million in one chance he is born in Venezuela and becomes a professional baseball player. And a million in one chance that he both has an AVM and that it ruptures.”
AVMs are rare, can form at a very young age, and frequently go undetected until it triggers dizziness, headaches, or seizures, which result in the AVM being identified in brain scans and medically managed or surgically removed. While ruptures are rare, occurring in roughly two percent of people with an AVM annually, the consequences can be severe, both in terms of damage to nearby brain tissue, but also the pressure that the bleeding and buildup of fluids puts on the brain. The stress response triggered in the body can also sometimes lead to complications with other organs as the body fights for survival.
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