Germline <i>EGFR</i> variants, however, have not previously been linked to epilepsy-related neuroimaging phenotypes.<h4>Case presentation</h4>We report a large multigenerational family in which multiple individuals presented with epilepsy, progressive cognitive impairment, and striking, bilateral mesiotemporal and thalamic MRI abnormalities. The gene discussed is EGFR; the disease is epilepsy.