ABSTRACT
This chapter provides a case of a 50-year-old electrician who presents to the emergency department with a 3-day history of an unsteady gait and double vision when looking to the right. He appears confused and gives a history of severe vomiting over the past 10 days with significant weight loss over the past few months. He has been abusing alcohol for 30 years and has been diagnosed with alcohol dependence. A thorough mental state examination is difficult due to his condition, but he does not appear to be responding to any unseen stimuli. He has little insight into why he is here. A general examination reveals bilateral pedal oedema and icterus. Neurological examination reveals reduced power in both lower limbs. He has reduced sensation on pinprick and two-point discrimination in both lower limbs. Deep tendon reflex at the ankle is reduced bilaterally. He has an unsteady gait and is unable to stand without support.
