DOI: https://doi.org/10.36347/sjmcr.2025.v13i10.061

Pages: 2452-2454

Background: Paraneoplastic neurological syndromes (PNS) are rare immune-mediated complications of cancer that may present with atypical cognitive or psychiatric symptoms, particularly in hematologic malignancies. Early recognition remains challenging. Case presentation: We report a 58-year-old man with Hodgkin’s lymphoma who developed generalized tonic–clonic seizures followed by an acute psychiatric syndrome characterized by persecutory delusions, disorientation, and agitation. Extensive investigations ruled out infectious, metabolic, and toxic causes. The findings were consistent with a probable paraneoplastic encephalitis, despite negative neuronal antibodies. Conclusion: This case highlights the importance for psychiatrists and clinicians to consider autoimmune and paraneoplastic encephalopathies in the differential diagnosis of acute psychosis and confusional states in oncology patients.