This 49-year-old man, previously healthy, was the victim of a collision by a drunk driver while he was bicycling 5 months prior to this assessment. His traumatic brain injury was severe and included a subarachnoid hemorrhage and hemorrhagic contusions of the brain. He demonstrated incremental improvements in speech and ability to interact with others as part of his rehabilitation program when, 4 months after his injury, he sustained a fall, which was followed by the appearance of rhythmic facial movements on the right side of his face and palate associated with deterioration in swallowing, speech, and memory. He could no longer swallow liquids and acted confused. He became unable to cooperate with further rehabilitation efforts and was sent to a nursing home. An electroencephalography (EEG) showed diffuse slowing but no epileptiform activity.