Article

[thereishope]

http://news.cincinnati.com/article/2010033...+monster+tumor+

 

Nightmarish tumor took her to brink

 

 

In a way, the devil almost got Kiera Echols.But doctors at University Hospital were able to diagnose the so-called "monster tumor" that was responsible for causing the hallucinations that had the Springfield woman demanding a priest perform an exorcism and chase the devil from her.In early November, Echols, 22, went to the doctor twice, thinking she had the flu. She was feverish and achy with a bad headache. A week or two after she started feeling bad, she passed out.Video: Echols' unusual caseHer parents, David and Chellie Givens, took her to a hospital, where doctors diagnosed her with meningitis. She spent six days in the hospital.But the same day she went home, she began hallucinating. She complained to her parents that children in the corner of her bedroom were fighting and being too noisy.Later in the day, she told her parents she was in labor, though she insisted she wasn't pregnant."She went around the living room and introduced us all to her baby," Chellie Givens said.Back to the hospital they went, about six hours after they left.Doctors there told her parents that Echols needed to be admitted to a psychiatric unit.But the Givenses didn't believe it. There was no family history of schizophrenia or bipolar disorder, which can both cause hallucinations, and she'd no signs of mental illness previously.Echols was transferred to the emergency department at University Hospital, where, as it turned out, she was in the right place at the right time."She was screaming at me to call a ... priest because she needed an exorcism," Chellie Givens said. "She was lunging at people. She was just completely psychotic."Within half an hour, doctors told her parents that they suspected Echols had an unusual form of encephalitis that was causing her hallucinations.And they'd already seen two cases of it that year."It looked very much like the beginnings of a schizophrenic or bipolar episode," said Christopher Kobet, a fourth-year neurology resident at University Hospital who helped pinpoint Echols' problem.But the real culprit wasn't in her head: It was a tiny tumor on her left ovary.The tumor was a teratoma, a freakish, but not uncommon, conglomeration of basic cells growing out of control. Some teratomas, if they're big enough, even contain eyeballs or tiny feet.Echols' body recognized the tumor as an invader, and developed antibodies against it, just like it would develop antibodies against a cold virus or a form of pollen she might be allergic to.Those antibodies attacked certain neurochemicals in the brain, triggering the encephalitis and the hallucinations.Doctors gave Echols steroids to bring down the swelling in her brain, and performed surgery to remove the tumor.The tumor was so small - less than a centimeter - that it wasn't visible on CT scans, said Ed Richards, the director of gynecologic oncology and advanced pelvic surgery at University. But they knew it had to be there.He was able to use robotic surgical techniques to find and remove the tumor."She was totally insane when she came in, to the point where she would lunge at you, thinking she had to defend herself against you," Richards said. "And a few days after the surgery, she was pretty much back to normal."Echols was lucky. Her form of encephalitis - called anti-NMDA receptor encephalitis - was identified only in 2007, though it's probably always been around. A doctor in Pennsylvania developed a way to test for the antibodies that trigger the disorder.University Hospital doctors had already seen two cases by the time Echols came in - one early in the year, and the second in the summer.And two weeks before Echols was admitted, they'd gotten additional training on the disorder."When I first saw it, I thought it was a once-in-a-lifetime thing, what we call a zebra," Kobet said. "But it's not rare at all."Now that doctors know it exists and how to test for it, more cases are cropping up.The implications of not making the right diagnosis are frightening."How many women, as recently as the 1950s and 1960s, were institutionalized with this because people thought they were schizophrenic?" Richards asked.And there's also the fact that encephalitis, if it's not treated, can be fatal, Kobet said.He submitted video of Echols to the American Academy of Neurology's Film Festival.Echols was released on Dec. 23. She's waiting to find out when she'll be cleared to return to driving and to go back to work. And she's working to raise awareness of what made her so ill.She doesn't remember much about the whole thing, other than wishing her husband, Mike, had been with her. Mike Echols, who is in the U.S. Air Force and stationed at Wright-Patterson, was in Texas for training at the time.But, having seen video that doctors took of her while she was psychotic, she worries about other people who might have the disorder and not know it."I know that wasn't me," she said.

[Ginger]

http://news.cincinnati.com/article/2010033...+monster+tumor+

 

Nightmarish tumor took her to brink

 

 

In a way, the devil almost got Kiera Echols.But doctors at University Hospital were able to diagnose the so-called "monster tumor" that was responsible for causing the hallucinations that had the Springfield woman demanding a priest perform an exorcism and chase the devil from her.In early November, Echols, 22, went to the doctor twice, thinking she had the flu. She was feverish and achy with a bad headache. A week or two after she started feeling bad, she passed out.Video: Echols' unusual caseHer parents, David and Chellie Givens, took her to a hospital, where doctors diagnosed her with meningitis. She spent six days in the hospital.But the same day she went home, she began hallucinating. She complained to her parents that children in the corner of her bedroom were fighting and being too noisy.Later in the day, she told her parents she was in labor, though she insisted she wasn't pregnant."She went around the living room and introduced us all to her baby," Chellie Givens said.Back to the hospital they went, about six hours after they left.Doctors there told her parents that Echols needed to be admitted to a psychiatric unit.But the Givenses didn't believe it. There was no family history of schizophrenia or bipolar disorder, which can both cause hallucinations, and she'd no signs of mental illness previously.Echols was transferred to the emergency department at University Hospital, where, as it turned out, she was in the right place at the right time."She was screaming at me to call a ... priest because she needed an exorcism," Chellie Givens said. "She was lunging at people. She was just completely psychotic."Within half an hour, doctors told her parents that they suspected Echols had an unusual form of encephalitis that was causing her hallucinations.And they'd already seen two cases of it that year."It looked very much like the beginnings of a schizophrenic or bipolar episode," said Christopher Kobet, a fourth-year neurology resident at University Hospital who helped pinpoint Echols' problem.But the real culprit wasn't in her head: It was a tiny tumor on her left ovary.The tumor was a teratoma, a freakish, but not uncommon, conglomeration of basic cells growing out of control. Some teratomas, if they're big enough, even contain eyeballs or tiny feet.Echols' body recognized the tumor as an invader, and developed antibodies against it, just like it would develop antibodies against a cold virus or a form of pollen she might be allergic to.Those antibodies attacked certain neurochemicals in the brain, triggering the encephalitis and the hallucinations.Doctors gave Echols steroids to bring down the swelling in her brain, and performed surgery to remove the tumor.The tumor was so small - less than a centimeter - that it wasn't visible on CT scans, said Ed Richards, the director of gynecologic oncology and advanced pelvic surgery at University. But they knew it had to be there.He was able to use robotic surgical techniques to find and remove the tumor."She was totally insane when she came in, to the point where she would lunge at you, thinking she had to defend herself against you," Richards said. "And a few days after the surgery, she was pretty much back to normal."Echols was lucky. Her form of encephalitis - called anti-NMDA receptor encephalitis - was identified only in 2007, though it's probably always been around. A doctor in Pennsylvania developed a way to test for the antibodies that trigger the disorder.University Hospital doctors had already seen two cases by the time Echols came in - one early in the year, and the second in the summer.And two weeks before Echols was admitted, they'd gotten additional training on the disorder."When I first saw it, I thought it was a once-in-a-lifetime thing, what we call a zebra," Kobet said. "But it's not rare at all."Now that doctors know it exists and how to test for it, more cases are cropping up.The implications of not making the right diagnosis are frightening."How many women, as recently as the 1950s and 1960s, were institutionalized with this because people thought they were schizophrenic?" Richards asked.And there's also the fact that encephalitis, if it's not treated, can be fatal, Kobet said.He submitted video of Echols to the American Academy of Neurology's Film Festival.Echols was released on Dec. 23. She's waiting to find out when she'll be cleared to return to driving and to go back to work. And she's working to raise awareness of what made her so ill.She doesn't remember much about the whole thing, other than wishing her husband, Mike, had been with her. Mike Echols, who is in the U.S. Air Force and stationed at Wright-Patterson, was in Texas for training at the time.But, having seen video that doctors took of her while she was psychotic, she worries about other people who might have the disorder and not know it."I know that wasn't me," she said.

 

 

This is so scary, but also so fascinating. "A doctor in Pennsylvania developed a way to test for the antibodies that trigger the disorder" we need a test like this for PANDAS!

[EAMom]

wow!

[peglem]

My 19 yo daughter was just dx'd with a teratoma cyst last week (in the ER). BUT no psychosis or MI symptoms. She's having it removed next Tuesday...surprising you posted this now.

[thereishope]

I am hoping to find time to write to the author of the article and brief her on PANDAS. I know it's not the same thing, but there's a bridge to the PANDAS topic hidden in there with symptoms of schizophrenia and bipolar and an autoimmune reaction. I'm from Cincinnati, I've written this newspaper before and never heard back from them. I just read that article thinking how "funny" they found this autoimmune reaction in this woman in Cinci, the same city as Don Gilbert.

Edited April 1, 2010 by Vickie

[Ginger]

I am hoping to find time to write to the author of the article and brief her on PANDAS. I know it's not the same thing, but there's a bridge to the PANDAS topic hidden in there with symptoms of schizophrenia and bipolar and an autoimmune reaction. I'm from Cincinnati, I've written this newspaper before and never heard back from them. I just read that article thinking how "funny" they found this autoimmune reaction in this woman in Cinci, the same city as Don Gilbert.

This article gives me hope! Not sure how to post a link, but I am going to try. Vickie thanks for posting the above article, of course I was then curious and found some more info that explains how the doctor found this connection. Good stuff

http://journals.lww.com/neurotodayonline/p...p;type=fulltext

[thereishope]

Interesting link! What I find more interesting is that only 58% had a tumor. What about the other 42%? Depending on the age, I could go as far as saying some of those could have possibly even been PANDAS or PITAND. Now I want to know more about this!

 

Thanks for posting that!

 

 

 

 

I am hoping to find time to write to the author of the article and brief her on PANDAS. I know it's not the same thing, but there's a bridge to the PANDAS topic hidden in there with symptoms of schizophrenia and bipolar and an autoimmune reaction. I'm from Cincinnati, I've written this newspaper before and never heard back from them. I just read that article thinking how "funny" they found this autoimmune reaction in this woman in Cinci, the same city as Don Gilbert.

This article gives me hope! Not sure how to post a link, but I am going to try. Vickie thanks for posting the above article, of course I was then curious and found some more info that explains how the doctor found this connection. Good stuff

http://journals.lww.com/neurotodayonline/p...p;type=fulltext

Edited April 1, 2010 by Vickie