A rare case of Dyke-Davidoff-Masson syndrome with concurrent metabolic syndrome

Dyke-Davidoff-Masson syndrome (DDMS) is a rare neurological condition resulting from prenatal or early childhood brain injury, characterized by seizures, hemiparesis, facial asymmetry, and intellectual disability, with imaging findings including cerebral hemiatrophy, calvarial thickening, and mastoid cell hyperpneumatization. We present the case of a 13-year-old male who exhibited recurrent convulsive seizures predominantly affecting his left side. MRI revealed right-sided cerebral hemiatrophy with ipsilateral calvarial thickening and mastoid hyperpneumatization, consistent with DDMS. Notably, this case was further complicated by coexisting metabolic syndrome, a rare comorbidity in DDMS, which increased the complexity of diagnosis and management. This case highlights the importance of considering DDMS in pediatric patients presenting with focal seizures and hemiparesis, and emphasizes the need to recognize atypical clinical associations such as metabolic syndrome. Early diagnosis and a multidisciplinary approach are essential to improve outcomes and guide future research into broader manifestations of DDMS.