Case of an 82-year-old female, with a history of myasthenia gravis, hypertension, and diabetes mellitus type 2 who developed unilateral facial drooping and left-hand weakness with associated seizures. Home medications included pyridostigmine 60 mg three times a day and mycophenolate mofetil 1000 mg twice a day. Levetiracetam every twelve hours was started without further seizures. Neurological examination was remarkable for an awake and oriented female, without fatigability but with left side hemiparesis. Initial Brain MRI with contrast revealed a right parietal lobe lesion and medial right occipital lesion. Our service was consulted in view of the patient's history of myasthenia gravis for optimization prior to emergent neurosurgical procedure. She was subsequently optimized with immunoglobulins. Post operative pathology report revealed neurotoxoplasmosis. On follow up Brain MRI there were no definitive residual enhancing components and there was an additional left anterior temporal pole juxtacortical enhancing lesion, not previously identified. Patient subsequently underwent treatment with intravenous sulfamethoxazole and trimethoprim combination for six weeks. Additional laboratory work up revealed positive hepatitis B surface and core antibodies. Mycophenolate mofetil was subsequently discontinued with plans of serial immunoglobulins as immunosuppressive therapy for myasthenia gravis maintenance treatment.