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Background: The Acquired Dyke-Davidoff Masson Syndrome (ADDMS) or cerebral hemiatrophy is rarely encountered case in common rehabilitation practice. Also there is lack of study which explores the physical therapy intervention and rehabilitation protocol. The aim of present study is to propose and explore the physiotherapy intervention based on literature available aimed to enhance functional recovery and cortical reorganization.Case Description: A 27 year old female presented with episodes of seizures and difficulty in performing ADLs with right upper extremity in physiotherapy OPD. At the age of 3 year, her parents reported that there was a developmental difference between right side upper and lower extremities with lack of movements. The MRI revealed evidence of Encephelomalacia with surrounding gliosis. There was also loss of volume of left cerebral hemisphere with mild ipsilateral calvarian thickening.Outcome: After the physiotherapy session the patient showed recovery in functional activity. However there was no any significant improvement in strength of muscles. Gripping and other fine motor skills was also improved in Upper extremity.Discussion: Plastic changes can occur at the cortical level in a number of ways. Evidences suggest that enriched environment and skill learning in adults are associated with growth of dendrites. Possible strategies to enhance the human brains response after injury can be a somatosensory stimulation, motor training, cortical stimulation and combination of sensory stimulation and motor training which is task specific.Conclusion: Physical therapy intervention improves the functional recovery in ADDMS.

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