Paraneoplastic neurological syndromes result from cancer’s immune impact on the nervous system.1 Anti-Ma-associated encephalitis causes diencephalic, brainstem, and limbic symptoms such as memory loss, narcolepsy and rapid eye movement (REM) behavior disorder (RBD), eye movement abnormalities, and parkinsonism. It can precede cancer diagnosis, often linked to testicular tumors. Agrypnia excitata (AE) is a unique electroclinical syndrome that can disrupt sleep structure with changes in physiological cyclic organization, autonomic overactivity, and oneiric stupor episodes. We report on a patient with anti-Ma encephalitis who exhibits a diencephalic syndrome and AE, not previously reported to our knowledge.