Brain on Fire (2018) Timeline Explained – Every Event in Order

Doctors dismissed Susannah's symptoms as exhaustion from overworking and partying too much because initial tests showed no abnormalities. Her MRI and EEG results came back normal, leading physicians to attribute her strange behaviors to stress, drug use, or mental illness rather than a neurological condition.

Foreshadowing: Early in the film, Susannah's boss comments on her intense work schedule, establishing that those around her believed she was simply overworking herself.

• misdiagnosis
• doctors
• exhaustion
• tests
• medical

Anti-NMDA receptor encephalitis is a rare autoimmune condition where the body's immune system attacks NMDA receptors in the brain, causing inflammation. Dr. Najjar describes it as 'a brain on fire' because the inflammation leads to the psychiatric and physical symptoms Susannah experienced, including seizures, psychosis, and catatonia.

• anti-nmda
• encephalitis
• autoimmune
• brain
• inflammation

Dr. Najjar asked Susannah to draw a clock, and she placed all the numbers on one side of the circle. This abnormal result indicated swelling in the right hemisphere of her brain, suggesting a neurological cause rather than a psychiatric one.

Foreshadowing: Earlier, Susannah's strange behaviors and sensory sensitivities had been dismissed as psychological issues, making this test a crucial turning point in her diagnosis.

• clock test
• brain swelling
• dr najjar
• diagnosis

Susannah was suspected to have schizophrenia because her symptoms included hearing voices, mood swings, erratic behavior, and psychosis, classic psychiatric manifestations of anti-NMDA receptor encephalitis. Since her MRI and EEG tests appeared normal, doctors assumed her condition was psychiatric rather than neurological.

Foreshadowing: Susannah herself wonders if she has bipolar disorder due to her extreme mood swings, showing how the symptoms mimicked mental illness.

• schizophrenia
• misdiagnosis
• psychosis
• mental health

Susannah's strange behaviors, including trance-like states, hearing voices that weren't spoken, aversion to loud sounds, and violent outbursts, were caused by anti-NMDA receptor encephalitis. The inflammation in her brain affected her neurological function, producing symptoms that appeared psychiatric but had a physical root.

Foreshadowing: Her initial symptoms began with a persistent cough and fatigue, resembling the flu before escalating to unexplained neurological disturbances.

• voices
• behaviors
• seizures
• inflammation
• symptoms

Susannah's violent outbursts, including the one during dinner that escalated to violence, were symptoms of her anti-NMDA receptor encephalitis. The inflammation in her brain affected her impulse control and emotional regulation, causing sudden aggressive behavior that was out of character.

Foreshadowing: Her parents had already noticed her erratic conduct intensifying, and her mother struggled to care for her as her condition deteriorated.

• violence
• outbursts
• aggression
• impulse control

Diagnosis was difficult because standard tests like MRI and EEG appeared normal, and the symptoms closely mimicked psychiatric disorders. Anti-NMDA receptor encephalitis was not widely known at the time, and only a brain biopsy could confirm the diagnosis by revealing the inflammation and anti-NMDA antibodies.

Foreshadowing: The film shows repeated tests coming back normal, creating frustration for her family and leading doctors down the wrong diagnostic path.

• diagnosis
• tests
• biopsy
• medical mystery
• doctors

After Dr. Najjar correctly diagnosed anti-NMDA receptor encephalitis through a brain biopsy, he began immune therapy treatment. This targeted the underlying autoimmune condition, reducing the brain inflammation and allowing Susannah to gradually recover her physical and mental faculties.

• recovery
• treatment
• immune therapy
• dr najjar

Susannah's condition deteriorated to a catatonic state as the inflammation from anti-NMDA receptor encephalitis spread across her brain. This severe neurological decline left her nearly unresponsive, marking the lowest point of her illness before Dr. Najjar's intervention.

Foreshadowing: Her condition had been progressively worsening despite various treatments, with each seizure and outbreak taking a greater toll on her neurological function.

• catatonia
• unresponsive
• worsening
• brain function

Susannah's memoir 'Brain on Fire' became instrumental in raising awareness of anti-NMDA receptor encephalitis. After being the 217th person diagnosed, her story helped thousands of others receive proper diagnosis and treatment, transforming a personal medical mystery into a resource for future patients.

• memoir
• awareness
• diagnosis
• impact
• book

Susannah's recovery took seven months after starting treatment for anti-NMDA receptor encephalitis. During this time, she underwent immune therapy to combat the inflammation, gradually regaining her cognitive and physical abilities until she could return to work.

• recovery
• seven months
• treatment
• time

Stephen, Susannah's boyfriend, is largely absent from the narrative during her illness. While the film establishes him early on, her parents take over her care as her condition deteriorates, and the focus remains on her medical journey rather than the romantic relationship.

• stephen
• boyfriend
• family
• care