Ophelia Syndrome: Rare Paraneoplastic Encephalitis Following Complete Metabolic Remission in Hodgkin Lymphoma.

Kumar, Srinivas Ananth; Balgi, Vishnu; Goyal, Harish; Keerthivasagam, Swaminathan; Halanaik, Dhanapathi · Clin Nucl Med · 2026

case_report · Level V

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Abstract

Paraneoplastic neurological syndromes (PNS), including limbic encephalitis, are rare associations with Hodgkin's lymphoma (HL), typically occurring before diagnosis. The term "Ophelia syndrome" describes this specific association. We report a rare case of paraneoplastic encephalitis developing after complete metabolic remission in a 16-year-old girl with HL, as assessed on 18 F-FDG PET/CT. Despite seronegative findings for autoimmune encephalitis panels, 18 F-FDG PET/CT demonstrated hypometabolic areas corresponding to magnetic resonance imaging Fluid-Attenuated Inversion Recovery (FLAIR) sequence hyperintensities, consistent with autoimmune encephalitis. This case highlights the importance of 18 F-FDG PET/CT in evaluating atypical neurological symptoms and suggests that PNS may arise even after apparent oncologic remission.

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