Ophelia Syndrome

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 18F-FDG PET/CT. Despite seronegative findings for autoimmune encephalitis panels,18F-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 18F-FDG PET/CT in evaluating atypical neurological symptoms and suggests that PNS may arise even after apparent oncologic remission.