You might want to rule out infection as a first step (strep and mycoplasma tests) especially if the changes were sudden.
My daughter had similar issues and ended up being diagnosed with PANS and later with autism. She didn’t have the typical autism characteristics, but we learned it’s often expressed differently in girls.
Long story short, she’s a high achiever and is studying to become an RN. Hang in there!
Strep is one of those pathogens being actively studied within this context by the PANS clinic at Stanford. It’s been shown to demonstrate “molecular mimicry” whereby its protein signature resembles various parts of our bodies (in the worst case)… with portions of the heart and brain (basal ganglia) occasionally being affected. I suspect there are other pathogens out there that can do the same, but who knows!
Yes we feel fortunate to be near Stanford. During the plasmapheresis procedure our daughter was intubated for 5 full days, which was necessary due to her psychotic state. However, when she woke up she had to endure several days of dealing with fentanyl withdrawal (180+ heart rate, severe hallucinations, etc.). After getting through that, her psychosis was gone but her OCD lingered. In our case the PEX wasn't quite enough so they did several ritux shotx. FYI - the latest thought is that rituximab is most effective when combined with methyltrexate, but not sure if the data on that have been published yet.
Through it all, I've learned much more than I ever wanted to know about horrific medical conditions, the latest research on systemic inflammation, psych meds, navigating medical insurance claims and who my real friends are. As an app developer, I tried to do my little part by releasing an iOS app to help track it all, but that doesn't feel like enough. Now I have some degree of normal back in my life, I'm looking into other ways to reach out and support those going through what I did, so feel free to reach out if you have any suggestions.
My direct experience backs up your conclusions. My 8 yr old daughter went from sweet, confident and carefree to, overnight, crippled by worries about germs, wetting the bed and screaming about everything. From there, she rapidly descended into what I can only describe as being possessed… hallucinations, erratic and sometimes violent behavior, refusal to eat and so on. We did a spect scan which showed her basal ganglia lit up, a condition uncommon for her age, so the doctor said to suspect infection. Sure enough, her blood work showed that she had active strep and mycoplasma infections with no traditional symptoms (fever, etc. ).
We then embarked on a hellish journey of long term antibiotics, countless ivigs,plasmapheresis, multiple shots of rhituximab and endless battles with the insurance companies. Even after her blood work finally improved (and her psychosis diminished) she still experienced crippling OCD. Her care team at Stanford explained that her immune system had been attacking her brain and that if the condition is not caught quickly enough it is often necessary to re-train the brain, similar to the case of a stroke. We sent her to a residential facility in Wisconsin, Rogers Memorial, for 4 months and they did an incredible job bringing her back to about 90%. At this point, she is still on long term prophylactic antibiotics - the same protocol as for cases of rheumatic fever - and is doing well.
We met other families with kids at Rogers who did not improve even after 6 months of intensive treatment there. In one case, this was because they did not address the active infection in their child. Our anecdotal experience leads me to believe that it often takes a combination of intensive immunotherapy and brain rehabilitation to get the poor souls afflicted with this terrible disease back to baseline. There are now several research facilities popping up around the world (USA, Sweden, China) trying to improve upon the protocol used to treat this. Hopefully the process will continue to improve and these cases will be caught sooner and require less treatment than my daughter did.
I built a remote controlled cat feeder with a simple servo controller loosely based on this blog: http://drstrangelove.net/2013/12/raspberry-pi-power-cat-feed...
Then I added a server instance and an iOS app so I could schedule / manually control feedings remotely. Great for short trips.