At the Bedside: UTHealth Houston physicians give 22-year-old second chance after rare brain condition led to psychosis

Struggling with seizures and deteriorating mental health, Addie Edwards embarked on a monthslong search for answers that would lead her from misdiagnoses and a psychiatric ward before she found help at UTHealth Houston. (Photo by Addie Edwards)

Addie Edwards was sitting in class when her lab partner’s service animal alerted on her. Moments later, Addie experienced her first grand mal seizure. She awoke outside, on a stretcher, looking up at clouds and the faces of concerned firefighters. When she experienced a second seizure two weeks later — and a third a day after that — everyone around her knew something was deeply wrong.

What first appeared as an isolated incident evolved into a monthslong search for answers that would lead Addie from emergency rooms and misdiagnoses to ineffective medications and a psychiatric ward before she found long-term care at UTHealth Houston.

“There are answers,” Addie said. “It’s really scary because you’re confused. Others are confused, and it just feels like there’s not a right answer. But it’s not the end-all be-all. There’s hope.”

EEG princess

In fall 2024, Addie, 21 at the time, enrolled as a freshman at Blinn College in Bryan, Texas.

“I started having more trouble keeping up with the cleanliness of my apartment,” Addie said. “Or just keeping all my ducks in a row. But really it was the seizures that started it all.”

She doesn’t recall an aura, a kind of premonition that a seizure is about to occur. “I blacked out totally,” she said.

Both Addie’s parents and her boyfriend visited her in the emergency room in College Station, Texas, where doctors found her condition stable and the seizure’s origins inconclusive. Her second seizure came two weeks later, while she toured Tarleton State University. Shortly after she was discharged from the hospital, she experienced a smaller seizure.

The situation had become serious, and hospitals didn’t provide answers. Her parents began looking for neurologists. Though Addie tended to take setbacks in stride, she found herself in spirits that, even for her, were unusually high. When she first received an electroencephalogram, which records brain activity through a crown of electrodes attached to the patient’s head, she felt like royalty.

“I was totally unfazed,” Addie said. “I look back, and I was like, ‘I’m a pretty princess. I’m going to be beautiful while I’m wearing this, this is going to be so much fun, this is going to be great.’”

Addie’s behavior grew more erratic. Her delusions lapsed into odd fixations, irrational communication, and agitation. 

“I started texting my boyfriend weird stuff,” Addie said. She was unusually preoccupied with separating “the good whites” from the other laundry, though she couldn’t specify what the good whites were. Congratulating her boyfriend for completing a job, she texted him, “Good green good green good green good green.” Later, in the psychiatric hospital, she would hallucinate that he was “a red devil.”

Addie’s longtime psychiatrist, whom she’d seen since late middle school, was concerned with treating her emerging psychosis and didn’t link the disorder to her previous seizures. But when Addie visited Samden Lhatoo, MD, a professor of neurology at McGovern Medical School at UTHealth Houston and neurophysiologist at UT Physicians, he suspected a connection.

“It’s relatively unusual for someone with epilepsy to have a severe psychiatric disorder of this kind,” Lhatoo said. He directs the epilepsy program at McGovern Medical School, co-directs the Texas Institute of Restorative Neurotechnologies, and holds the John P. and Kathrine G. McGovern Distinguished Chair at the school. “In a teaching hospital, in neurology, we expect to see interesting cases like this that are not diagnosable or not suspected out there in the community.”

At her initial appointment, Addie’s diagnostic bloodwork suggested the presence of antibodies targeting her NMDA receptors, which alerted Lhatoo to a potential explanation for her symptoms. The follow-up testing necessary to confirm a diagnosis, however, would be put on hold as Addie’s mental health deteriorated. She tried several medications that were ultimately unsuccessful at alleviating her psychosis, which erupted when she attacked her father in early December 2024.

Christmas in the psychiatric hospital

Addie began the holiday season in the waiting room of an inpatient psychiatric facility in The Woodlands, Texas, where she couldn’t answer the intake questions.

“‘Where are you? What day is it?’” Addie recalls the staff asking. “I remember not being able to answer her — I knew the answers, but I couldn’t articulate it, and I was getting really angry and upset about it.”

She arrived there after her brother found her standing on their driveway, barefoot, in a daze. She had told her family that she needed to go for a run. He called their father, Matthew Edwards, for help, who decided that Addie needed immediate intervention. But when he suggested they were going to take her somewhere, Addie became irate.

“I was viscerally upset,” she said. “I got angry. I started punching him. I punched him till he bled. I fought my dad. They had to tie me up to get me in the car, with rope and duct tape… anything they could to keep me stable.”

Addie was hospitalized until late January 2025. It’s a time she doesn’t remember much — largely black holes in her memory, similar to the lapses caused by epilepsy — though several blips of color twinkle in the dark.

“I get the good end of the stick with my memory of inpatient,” Addie said. “I get to remember the silly things. I liked the chili they had on Tuesdays. We had root beer floats on Sunday. Or we got to watch a Madea Christmas one day. I remember some of the faces of some of my nurses that I liked.”

Addie currently studies geoscience at Tarleton State University in Stephenville, Texas. (Photo by Addie Edwards)

While many were at home celebrating Christmas among family, Addie was trying a variety of medications that proved ineffective; many only increased her agitation. Thanks to her parents, however, the holiday came with a rain check: When Addie’s condition began to stabilize, she was discharged and returned home to a second Christmas, which her parents threw for her at the end of January. She opened presents, took pictures, and was reunited with her cat. 

“I’m very blessed and lucky to have such a supportive family who was able to care for me so deeply,” Addie said. “They dropped everything for me.”

As the fog of psychosis broke and her memory clarified, Addie recalls driving to electroconvulsive therapy (ECT) in mid-January. Ultimately, ECT would return her to full lucidity. 

However, she still required constant supervision. She knew it was necessary, but she was also frustrated with how long her life had been on pause.

“I had gotten so sick and tired of being coddled,” Addie said. “I was so ready to be independent again, having gone from independent life to 24/7 care, being treated like a toddler.”

Addie was losing patience and hope. Most of all, she lacked answers. To find them, her family returned to UTHealth Houston, where Addie underwent a battery of tests to discover the root cause of her epilepsy and psychosis.

Connecting the dots

To treat Addie, Lhatoo worked with Rajesh Gupta, MBBS, associate professor of neurology and director of the Autoimmune Neurology Clinic at McGovern Medical School. Gupta specializes in neuroimmunology, particularly on autoimmune disorders. It’s an area where critical conditions are newly identified or better understood every day, a field in which Gupta felt he could make a lifesaving difference.

Together, Lhatoo and Gupta worked to confirm what Lhatoo suspected when he first saw Addie in November. They performed an electroencephalogram and an MRI, analyzed blood multiple times a week, and tried to induce a seizure through several methods, including an exercise stress test, strobe lights, and sleep deprivation. Eventually, they placed Addie in an epilepsy monitoring unit.

“I felt like a human pincushion,” Addie said.

When the team performed a spinal tap, the results were certain: Addie’s brain was inflamed — a condition called encephalitis — and antibodies were targeting her NMDA receptors. 

Not formally recognized until the early 2000s, anti-NMDA receptor encephalitis is an autoimmune disorder in which the body attacks the brain’s NMDA receptors. These receptors are vital for a healthy brain and nervous system. They influence movement and memory, and their dysfunction is implicated in Alzheimer’s, Parkinson’s, epilepsy, psychiatric disorders, and other chronic diseases.

“It was a condition that was suspected, but nobody had a test for it,” Lhatoo said. “Nobody really knows what the trigger is. In Addie’s case, it was autoimmunity for no clear reason.”

Because it can present as epilepsy or a psychiatric disorder, the condition is often misdiagnosed. Swift care is critical — the sooner a patient is treated, the better their prognosis. Patients whose cases are identified and treated early on generally make a full recovery. If left untreated, anti-NMDA receptor encephalitis can cause irreversible brain damage or death.

“These cases teach us a very good lesson,” Gupta said. “Even though patients have a history of psychiatric disorders, we should not just by reflex consider that, ‘Oh, this is the worsening or recurrence of the same psychiatric disorder.’”

Six months after her first seizure, Addie had an answer. “It explains the seizures, the psychosis, the catatonia, the grandeur, and all of it. That’s why the ECT worked, because it was shocking my brain so that the inflammation went down.”

The UTHealth Houston team gave Addie intravenous immunoglobulin infusions to control the encephalitis. Gupta is also investigating the viability of an experimental drug that could more effectively target anti-NMDA receptor encephalitis. Addie is a potential candidate for this study.

“If it means I can be part of this study that helps other people get the necessary medicine so that they don’t have to go through what I went through and have to put such a pause on their life, of course why wouldn’t I?” Addie asked.

A future with hope

Today, Addie is back to a normal life. She attends Tarleton in Stephenville, Texas. She bikes to class and exercises. She takes regular immunotherapy infusions and observes the precautions that come with immunosuppressants, like wearing masks in airports and doctors’ offices.

“It’s insane, the total 180 that happened,” Addie said. “We thought there would be some side effects, like maybe I would have migraines or general haze. But it’s been night and day. Dr. Lhatoo and his team, Dr. Gupta, they’ve been incredible.”

After a long time looking for answers in the dark, Addie has come to trust that there are always options, even in situations that appear hopeless. She’ll know that trust for the rest of her life.

“There are options, and there are people, relying on those who can care for you,” Addie said. “My boyfriend was there for me, my parents were there for me, all these people were there for me.

“I’m so blessed that at my young age of 22 I’m able to go back to my normal life,” she said. “There are answers… There’s hope.”