We present the case of a young man in his early thirties who sought medical attention after a witnessed seizure episode. His drug screen revealed the presence of cocaine, marijuana, and benzodiazepines. To investigate any potential structural causes contributing to his seizure, we conducted an MRI of the brain, which revealed polymicrogyria. This structural abnormality is strongly associated with seizures. This case emphasizes the importance of ruling out underlying structural causes of seizure disorders in patients with a history of drug abuse before recommending cessation of drug use.