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Case Report Volume 16 Issue 4
Late diagnosis of acquired Dyke–Davidoff–Masson syndrome after childhood meningoencephalitis in a 34‑year‑old man: a case report
Najoua Mouloudi, Amine Reggabi, Houda Alloussi, Amal Satte
Received: October 05, 2026 | Published: October 20, 2026
Citation: Mouloudi N, Reggabi A, Alloussi H, et al. Late diagnosis of acquired Dyke–Davidoff–Masson syndrome after childhood meningoencephalitis in a 34‑year‑old man: a case report. J Neurol Stroke. 2026;16(4):182-185. DOI: 10.15406/jnsk.2026.16.00670
Abstract
Background:
Dyke–Davidoff–Masson syndrome (DDMS) is a rare condition characterized by
cerebral hemiatrophy with compensatory ipsilateral calvarial thickening and
hyperpneumatization of the paranasal sinuses and mastoid air cells, clinically
associated with seizures, contralateral hemiparesis and intellectual
disability.
Case
presentation: A 34-year-old man presented with focal clonic seizures of
the left upper limb, occurring about once a week and sometimes evolving to
bilateral tonic-clonic seizures, despite carbamazepine and phenobarbital. Born
at term with an uneventful perinatal period and normal psychomotor development
until the age of 3 years, he was then admitted to the intensive care unit for
status epilepticus revealing meningoencephalitis, and was discharged with
residual left hemiparesis and epilepsy. Examination showed left spastic
hemiparesis, facial asymmetry, and cognitive impairment (MMSE 18/30). MRI
revealed right cerebral hemiatrophy with ex vacuo ventricular dilatation, ipsilateral
calvarial thickening and sinus hyperpneumatization, and contralateral
cerebellar atrophy. EEG showed right-sided slowing with right temporal
interictal discharges activated by sleep. The diagnosis of DDMS had never been
made and was established only at the age of 34 years, 31 years after symptom
onset. After phenobarbital was tapered off and replaced by lacosamide, seizure
frequency decreased from about one per week to one per month.
Conclusion:
This case illustrates the acquired form of DDMS after childhood
meningoencephalitis and emphasizes the long diagnostic delay that may occur in
this syndrome. Neuroimaging should be performed in any patient with
childhood-onset hemiparesis and epilepsy, as early diagnosis allows timely
recognition of drug resistance and optimization of management.
Keywords: Dyke–Davidoff–Masson syndrome, cerebral hemiatrophy, crossed cerebellar atrophy, delayed diagnosis, meningoencephalitis, drug-resistant epilepsy
©2026 Mouloudi, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.