We report a patient newly diagnosed with cortical dysplasia upon magnetic resonance imaging (MRI) in his eighth decade of life after a recent syncopal attack. The neurological examination and laboratory findings were normal. His cranial MRI revealed a lesion giving a low signal on T1-weighted images, which was evaluated as focal cortical dysplasia. No treatment was given, and he did not have any further syncopal or epileptic attacks during the subsequent two-year follow up. No previous study has described such a case of malformations of cortical development (MCD) in patients older than 70. Especially in asymptomatic or clinically less severe patients, the underdiagnosis of MCD may result in a clinical spectrum that is too narrow to reflect the reality (Fig. 1, Ref. 6).