A 50-year-old man with epilepsy from age 6 presented with seizures and personality change. Neuroimaging demonstrated left cerebral hemiatrophy, calvarial thickening, and increased frontal sinus pneumatization. There was a small, left frontal lobe hemorrhage (not shown), presumably from unwitnessed trauma. The appearances (figure 1) were compatible with Dyke-Davidoff Masson (DDM) syndrome.1 He remains seizure-free on an increased dose of sodium valproate. His personality changes persist.