Delusion of pregnancy is relatively rare phenomenon encountered in psychiatric patients but is reported frequently in developing countries. It can be associated with both psychiatric and neurological disorders. We are reporting a case of delusion of pregnancy that developed in a drug-naïve young woman secondary to auditory hallucination with normal body mass index with no neurological cause due to paranoid schizophrenia. Till date, only seven such cases were reported where auditory hallucinations were reported along with the belief in pregnancy. It should be differentiated from pseudocyesis/pseudopregnancy/simulated pregnancy/Couvade syndrome. Workup should include the identification of the psychosocial/cultural factors leading to the development of this phenomenon, although pharmacological treatment remains the mainstay of the treatment.

Central pontine myelinolysis (CPM), is a potentially fatal neurological disorder identified by demyelination at the bottom of the pons. Osmotic stress, endothelial dysfunction, blood–brain barrier damage, and rapid correction of hyponatremia believed to be the main causes. Chronic alcoholism may influence the CPM. We report a case of chronic alcoholism and normonatremia, who presented with sudden onset of drowsiness and quadriparesis, after sudden abstinence from alcohol who was eventually diagnosed with CPM. Evidence of elevated serum ammonia level indicated encephalopathy. Our case emphasizes that CPM can manifest in patients with chronic alcoholism. CPM must be distinguished from the natural course of alcohol withdrawal delirium and Wernicke's encephalopathy, which necessitates clinical astuteness and a high level of suspicion on the part of the physician.

Organic and non-organic illnesses may present with uncommon symptoms. In some cases, the presenting atypical symptoms make a prompt and accurate diagnosis difficult. Accordingly, unequivocal psychotic and affective symptoms also require adequate evaluation before determining the diagnosis and management. Here we present a case whose presenting symptoms strongly suggested an organic etiology, namely autoimmune psychosis, but failed to be diagnosed as such through laboratory tests and didn't respond to appropriate treatment. Re-evaluation of the case revealed significant past psychiatric history, suggesting functional psychosis but the patient did not respond to anti-psychotic medications either. This case therefore highlights the importance of complete unbiased work-up for all psychoses.