29.05.2024

A woman who woke up after 20 years in a catatonic state could hold key to curing others

A woman trapped in her own mind for two decades has woken up and is able to be with her family again thanks to a revolutionary new treatment.

April Burrell was just a 21 in 1995 when she suffered a traumatic event while studying accountancy at university in , US, that left her suffering from constant visual and auditory hallucinations.

She was diagnosed with a severe form of schizophrenia, a devastating mental illness that dramatically alters sufferers’ sense of reality.

April spent the next 20 years trapped in a cationic state, unable to recognise her family and having her every need cared for in a psychiatric hospital in New York.

Until one day, she woke up thanks to a team of medics who treated her for lupus — a disorder that they discovered was causing her immune system to attack her brain.

Her doctors hope the discovery could help treat hundreds of patients in a similar situation.

A woman in the US  awoke from a catatonic state after medics discovered her condition was actually being caused by a treatable condition where her immune system was mistakenly attacking her brain in a discovery that could give hope to other patients (stock image)

A woman in the US  awoke from a catatonic state after medics discovered her condition was actually being caused by a treatable condition where her immune system was mistakenly attacking her brain in a discovery that could give hope to other patients (stock image)

Professor Sander Markx, director of precision psychiatry at Columbia University, was one of the team of medics who treated April.

In a bizarre coincidence, he told the Washington Post how he had met April back when he was just a medical student, and the memory of her stayed with him.

‘She would just stare and just stand there,’ he said. ‘She wouldn’t shower, she wouldn’t go outside, she wouldn’t smile, she wouldn’t laugh. And the nursing staff had to physically manoeuvre her.’

Almost two decades later Professor Markx would meet April again after one of his students went to the same psychiatric hospital and spoke about meeting the same woman.

Shocked there had been no improvement in 20 years, Professor Markx spoke to her family and gathered a team of experts to run a full analysis on her condition.

Professor Sander Markx, director of precision psychiatry at Columbia University, was one of the team of medics who treated the woman, and said there could be other ‘forgotten’ patients who could be similarly helped

They found sings of lupus in her blood work.

Around 50,000 Brits and 1.5million people in the US are thought to suffer from the long-term autoimmune condition. More women than men suffer from the condition.

The cause is not fully understood, but a viral infection, some medications, sunlight, puberty and menopause are all thought to be possible causes.

It is unknown if April’s earlier traumatic experience had triggered lupus, or if the development of the disease was a coincidence.

Brain scans showed evidence that April’s immune system was attacking her temporal lobes, which are vital for processing information and emotions as well as language.

April’s case was unusual as normally lupus attacks areas like the skin, joints, kidneys and heart, not the brain.

And in her case, the condition was only attacking the brain, meaning there were no other, more obvious, symptoms she had the condition.

But now it had been found, the disease could be treated.

The process was long and arduous. April needed to undergo immunotherapy treatment using powerful drugs to bring her immune system back into line.

This treatment would end up taking a year, due to the need to take a month-long break between rounds of medication to let the immune system recover.

Tests requiring her to drawing a clock — a common way of measuring cognitive ability — showed promise.

Prior to treatment, April’s drawings were akin to those of a dementia patient — meaningless scribbles.

But, slowly, over the months that followed she started to draw one half of a clock face, then an almost perfect one.

Then, after a year of treatment, April woke up in 2020 and was able to meet her family again in 2021 after Covid visiting restrictions were lifted.

Her brother, Guy Burrell, recalled: ‘When she came in there, you would’ve thought she was a brand new person.

‘She knew all of us, remembered different stuff from back when she was a child.’

While a source of joy to one family, April’s recovery could also give hope to hundreds of other patients who may be trapped in a similar mental state from a treatable condition.

Although experts suspect the portion of patients whose catatonic state is caused by an autoimmune condition like lupus is small, Professor Markx said it should be considered.

‘These are the forgotten souls,’ he said. ‘We’re not just improving the lives of these people, but we’re bringing them back from a place that I didn’t think they could come back from.’

Clinicians in New York have already found 200 patients in care in the state similar to April that may benefit, and similar research is underway in the UK and Germany.

WHAT IS SCHIZOPHRENIA?

Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves.

People with schizophrenia may seem like they have lost touch with reality.

The cause of schizophrenia is not understood and it is believed to be a mix of genetics (hereditary), abnormalities in brain chemistry and/or possible viral infections and immune disorders.

Symptoms of schizophrenia usually begin between ages 16 and 30. In rare cases, children have schizophrenia too.

The symptoms of schizophrenia fall into three categories: positive, negative, and cognitive.

Positive symptoms are disturbances that are ‘added’ to the person’s personality and include:

  • Hallucinations
  • Delusions
  • Thought disorders (unusual or dysfunctional ways of thinking)

Negative symptoms are capabilities that are ‘lost’ from the person’s personality and include:

  • ‘Flat affect’ (reduced expression of emotions via facial expression or voice tone)
  • Reduced feelings of pleasure in everyday life
  • Difficultly beginning and sustaining activities

Cognitive symptoms are changes in their memory or other aspects of thinking and include:

  • Trouble focusing or paying attention
  • Problems with ‘working memory’
  • Poor ability to understand information and use it to make decisions

Figures suggest around one percent of the world population suffers from schizophrenia with around two million in the US.

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