A 21-year-old male with history of refractory epilepsy presented for long-term video EEG monitoring. His home antiepileptic medications were weaned off over a seven-day period. On hospital day 4, he had a right temporal electro clinical seizure with secondary generalization and a second right temporal electrographic seizure. On hospital day 8, MRI brain identified an ovoid circumscribed lesion in the splenium of the corpus callosum which had not been present on prior scans (Figure 1).