Ripgrep author BurntSushi recounts brush with anti-NMDA receptor encephalitis

Andrew Gallant, the open-source developer behind ripgrep and other widely depended-on Rust tooling, has disclosed that the gap in his recent activity was caused by anti-NMDA receptor encephalitis, an autoimmune disorder in which antibodies trigger brain inflammation. Symptoms began as flu-like physical complaints and escalated into jaw pain, loss of balance, psychosis, hallucinations and suicidal ideation. After an initial misdiagnosis sent him to an in-patient psychiatric facility, a personal connection eventually routed him to neurology at Brigham and Women’s Hospital, where MRIs, a lumbar puncture and CSF antibody testing confirmed the disease.

Early empirical treatment with IVIG and methylprednisolone — started before the formal diagnosis — produced rapid improvement, and he is now tapering steroids and enrolled in the CIELO trial of satralizumab. Prognosis is good given the early catch. He singles out the psychiatric-to-neurology handoff as the one point where the health-care system failed him, and notes the condition is commonly mistaken for generalized anxiety or schizophrenia.

For projects depending on his work, the upshot is that he is returning to activity. He credits his wife Kaitlyn Brady and his employer-side colleague Charlie Marsh (of Astral/uv/Ruff) for support during the months he was out, and signs off characteristically with ‘happy hacking.’