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Paraneoplastic Limbic Encephalitis in Hodgkin′s Lymphoma Misdiagnosed as Isoniazid Psychosis: A Mystifying Experience

© 2020 Neurology India, Neurological Society of India | Published by Wolters Kluwer ‐ Medknow Sir, As per the GLOBOCAN 2012 data, the age‐standardised incidence rates of Hodgkin’s lymphoma (HL) in India is 5677 per 100,000 population and of non‐Hodgkin’s lymphoma (NHL) is 15,883 per 100,000.[1] While the incidence of lymphoma is lesser in India when compared to developed countries, the mortality rate is almost equal. This can be ascribed to factors like delayed diagnosis owing to inadequate diagnostic facilities in rural India, affordability issues, incomplete treatment, and poor follow‐up.[2] Poor diagnostic facilities often result in misdiagnosis of malignant lymphadenopathy as tubercular lymphadenitis. The picture gets complicated when malignancy presents with atypical manifestations like paraneoplastic neurological syndromes (PNS), as in our patient. With this case report we underline the risk of misdiagnosis by fine‐needle aspiration cytology (FNAC), need for improvement in tissue diagnostic facilities in rural India, and importance of repeat neuroimaging at proper intervals to clinch the diagnosis of unusual cases.