<p>Feline hyperesthesia syndrome (FHS) is a complex and poorly understood condition characterized by episodic behavioral disturbances, often associated with environmental, neurological, and psychogenic factors. This case report describes the clinical presentation, diagnostic approach, and management of a 43-month-old spayed mixed-breed female cat with a one-year history of behavioral alterations, including lumbar tremors, tail chasing, and sudden aggressive episodes. The onset of clinical signs was temporally associated with a significant environmental change, namely the birth of the owner’s child, which may have acted as a potential stressor; however, a causal relationship cannot be established. Physical examination and hematological evaluation revealed no abnormalities, allowing the exclusion of systemic and dermatological diseases. Due to financial limitations, advanced neurological assessment and imaging investigations were not performed, and a presumptive diagnosis of FHS was established based on clinical history and exclusion criteria. Management was primarily based on multimodal environmental modification (MEMO) strategies aimed at reducing stress and improving behavioral welfare, with adjunctive use of a homeopathic formulation (Anizen^®). Follow-up evaluations demonstrated a reduction in the frequency and severity of episodes, decreasing from daily occurrences to one or two mild episodes per month, along with improvement in social behavior. This case highlights the importance of environmental and behavioral factors in the clinical expression of FHS and supports the role of structured environmental management as a central component of therapy. Despite the inherent diagnostic limitations, improvement in quality of life remains the primary therapeutic goal, emphasizing the relevance of individualized, multimodal approaches in affected cats.</p>