ABSTRACT
A 73-year-old man was brought to hospital by a friend who felt that he had become increasingly confused over the preceding 4–5 weeks. The patient described a generalised sense of disorientation and difficulty remembering how to perform simple activities such as dressing himself. He was becoming progressively more unsteady when walking and had fallen several times over recent days. Of note, he had fallen 6 weeks earlier and sustained a head injury while travelling on a train. His past medical history included juvenile myoclonic epilepsy. He took 500 mg sodium valproate BD and primidone 250 mg BD. He was a retired history teacher who lived alone and was usually independent with activities of daily living. He had never smoked tobacco and did not drink alcohol.
