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The Parlour Royale Cafe. For the love of reading TT Community Organization. This is not wrong. In fact, at the time, it was seen as revolutionary and is a fundamental part of disability history. Using identity-first language makes disability a marker of pride. To be clear, many disabled activists behind SayTheWord use identity-first language interchangeably with person-first language. Both types should be embraced and accepted. Yes, this is messy, because there is no overall consensus within the disabled community on whether identity-first language versus person-first language is best. Identity-first language is not offensive.

These euphemisms are doing more harm than good because they reinforce the negative stereotype that disability should be feared. And disabled people are tired of non-disabled people telling us what they think is best for us. She was finally diagnosed with anti-NMDA receptor encephalitis, a rare autoimmune condition that attacks the brain and was first described just seven years ago. After being prescribed steroids, which reduce inflammation, and an immune therapy that attacked the offending antibodies, Cahalan recovered her health.

It is a disconcerting, unmistakable illness to witness.

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Disguised, it evades the immune system just long enough to establish an infection. But sometimes this tactic sets off an unfortunate chain of events. In classic rheumatic fever, the antibodies mistake the lining of the heart for strep bacilli. The basal ganglia are walnut sized areas of the brain that serve as a sort of traffic light, signaling the muscles in the proper order to make voluntary movements. When the basal ganglia are damaged or attacked, the disruption can be severe—as though the traffic light was permanently stuck on green.

But in about a quarter of the childhood-onset OCD cases Swedo looked at, the compulsive behavior came on like a light switch, going from normal to severe overnight. It was often accompanied by tics, like throat clearing and grunting; severe separation anxiety; bed-wetting; and changes in handwriting as fine motor control broke down. In classic autoimmune diseases like Type 1 diabetes or lupus, the immune system spontaneously mistakes cells in the body for invaders.

As long as the immune system senses strep in the body, it produces antibodies tailored to fight the bacteria.

In people with PANDAS, though, the antibodies slip through the blood-brain barrier to attack similar-looking proteins on the cells of the basal ganglia. When it comes to treatment, the presence of strep antibodies in the blood of children with OCD is a positive sign. Remove the infection, and the crippling behaviors often go away, too.


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Artificially dampening the immune system seems to work in a similar way. He seemed better than percent. The average grade school student comes down with strep twice a year, according to the National Institutes of Health.

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Swedo agrees that traditional treatments—cognitive behavior therapy, for example—are part of the solution. The immediate response to antibiotics and immune-suppressants underscored the connection between the compulsions and volatility of children with PANDAS and their strep infections.

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Swedo and her colleagues realize that mental disorders caused directly by infection or autoimmune reaction are the exception rather than the rule. How can that be? Both advocates and critics of PANDAS agree that mental disorders like OCD, depression, or schizophrenia, in children and adults, should be looked at as a set of symptoms with a variety of possible causes.

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Genes, environment, and immunity all interact in ways doctors are just beginning to unravel. As doctors and scientists return to an earlier, holistic understanding of the relationship between body and brain, they are potentially gaining new treatments for terrifying illnesses. Andrew Curry is a journalist in Berlin, Germany. He has written for a wide range of publications, including Archaeology, Discover, National Geographic, and Wired. You can follow him on Twitter spoke Bernstein, G. Comparison of clinical characteristics of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and childhood obsessive-compulsive disorder.

Journal of Child and Adolescent Psychopharmacology 20 , — Garvey, M. Lessons from rheumatic fever. Journal of Child Neurology 13 , Khandaker, G. Inflammation and immunity in schizophrenia: Implications for pathophysiology and treatment. The Lancet Psychiatry 2 , —